Upper GI - Surgery Flashcards
What are the treatment options for metastatic/unfit patients with oesophageal cancer?
Stenting
Palliative radiotherapy
Palliative chemotherapy
What are the treatment options for resectable/fit patients with oesophageal cancer?
Oesophagectomy + chemotherapy (5 year survival ~45%)
Concerns about resection/fitness and no metastatic disease = chemo/radiotherapy (5 year survival ~30%)
What are the 3 different approaches to oesophagectomy?
Ivor Lewis
Trans-hiatal
Left thoraco-abdominal
What is the morbidity rate for oesophagectomy?
20-30%
What is the mortality rate for oesophagectomy?
5%
How long does it take post-oesophagectomy to return to pre-op quality of life?
10 months
What are the modifiable risk factors of stomach cancer?
Infection with H. pylori virus
Alcohol
Smoking
Excessive consumption of salted fish, picked vegetables and cured meats
What are the ALARM symptoms of stomach cancer?
Anaemia Loss of weight Anorexia Recent onset of progressive symptoms Masses and maelaena/haematemesis Swallowing difficulty
What are the surgeries for gastric cancer?
Subtotal gastrectomy - saves top part of stomach if tumour is in lower part of stomach
Total gastrectomy and roux en Y reconstruction - jejunum pulled up to oesophagus, duodenum attached further down small intestine
What are the 2 ways for gastrectomy?
Laparoscopic distal gastrectomy
Open gastrectomy
What is the anti-reflux surgery for GORD?
Hiatus hernia repair
What are the side effects of laparoscopic hiatus hernia repair and fundoplication?
Dysphagia Difficulty to belch and vomit Gas bloating Excess flatulence Diarrhoea
What BMI range for conventional treatment?
30.0 - 34.9
What BMI range for obesity surgery?
35.0 +
