Upper GI surgery

Question 1

What is the 5ys of oesophageal cancer with oesophagectomy/chemo?

Answer 1

45%

Question 2

What are options for treating oesophageal cancer?

Answer 2

Stent to allow swallowing if blocked
Palliative radiotherapy
Palliative chemotherapy
Oesophagectomy

Question 3

Dos squamous cancers respond better to chemo or radiotherapy?

Answer 3

Chemotherapy

Question 4

What are some risk factors of gastric cancer?

Answer 4

H. Pylori
Alcohol
Smoking
Salted fish, pickled egg, cured meats

Question 5

How does gastric cancer present?

Answer 5

Dispepsia (especially with anaemia)

ALARM

Question 6

What does ALARMS stand for?

Answer 6

Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses and malaena/haematoma
Swallowing difficulty

Question 7

What are some useful investigations for gastric cancer?

Answer 7

Endoscopy

Contrast swallow

Question 8

What are some surgical options for treating gastric cancer?

Answer 8

Subtotal gastrectomy

Total gastrectomy with Roux en Y reconstruction

Question 9

What is Roux en Y reconstruction?

Answer 9

Stomach size permanently reduced by stapling across to divide the top of the stomach
Jejunum then reattached to new pouch
Bypassed duodenum then reattached lower down the jejunum

Question 10

What are some useful investigations for reflux?

Answer 10

Endoscopy
pH studies
Manometry

Question 11

What is the limit for “normal” acid reflux?

Answer 11

Reflux for 4% of the day is considered normal

Any more is cause for concern

Question 12

What are some side effects of laparoscopic hiatus hernia repair and fundoplication?

Answer 12

Dysphagia
Difficulty belching or vomiting
Bloating
Excessive flatulence
Diarrhoea