Upper GI Surgery

13 flashcards · Other · by Anonymous Sloth

1. Investigations involved in upper GI pathology

   Endoscopy Contrast swallow

2. Principles of staging in upper GI cancer

   Use of a CT chest/ abdomen Metastatic/unfit No more staging needed Palliation and supportive treatment Resectable/fit Endoscopic ultrasound (T/N stage) PET CT (M stage)

3. Treatment options

   Metastatic/ unfir Stenting Palliative radiotherapy Palliative chemotherapy Resectable/fit Oesophagectomy + chemo (45% 5 year survival) Chemo/radiotherapy (no metastatic disease)

4. Principles of Oesophagectomy

   Approach Ivor lewis (incision in the right thoracic area and the abdomen) Trans-hiatal (incision in neck and stomach) Left thoracic-abdominal Conduit Stomach Colon Morbidity 20-30% Mortality 5% Return to pre-op QOL 10 months

5. Features of stomach cancer

   5th most common malignancy Difficult to detect and is diagnosed typically at its later stages (stage IV) - 4% survival rate)

6. Modifiable risk factors of gastric cancer

   Helicobacter pylori infection Alcohol Smoking Excess processed and cured food consumption

7. Presentation of gastric cancer

   ALARM Anaemia Loss of weight Anorexia Recent onset of progressive symptoms Swallowing difficulty

8. Investigations for Gastric cancer

   Upper GI endoscopy Indicated by presence of ALARM symptoms and over age of 55 Contrast meal (barium)

9. What occurs after diagnosis of malignancy

   Staging and grading the cancer to determine how far along it has progressed C chest/abdomen Staging laparoscopy

10. Principles of gastric cancer surgery

    Subtotal gastrectomy Total gastrectomy and roux en y reconstruction

11. Presentation of GORD

    Chest pain Heartburn Dysphagia Sour taste in mouth Difficulty breathing, wheeze and cough Excessively salivating Tooth erosion Belching

12. Causes of GORD

    Hiatus hernia

13. Investigations for GORD

    Endoscopy Oesophageal pH study and manometry (LOS pressure)