Upper GI Surgery Flashcards Preview

07. Year 2: Alimentary System > Upper GI Surgery > Flashcards

Flashcards in Upper GI Surgery Deck (70)
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1

What are some examples of conditions that often require upper GI surgery?

Oesophageal cancer

Gastric cancer

Anti-reflux

Bariatric surgery

2

How does the incidence of oesophageal cancer compare between men and women?

3x higher in men

3

How many people with oesophageal cancer survive 10 years?

10%

4

Why is the prognosis of oesophageal cancer so poor?

Symptoms present late

5

What are common traits of people who end up getting oesophageal cancer?

Smoke

Eat little fruit and veg

Overweight

Drink alcohol

6

What are the 2 kinds of oesophageal cancers?

Adenocarcinoma

Squamous cell carcinoma

7

Where in the oesophagus does adenocarcinoma occur?

Distal oesophagus

8

What are risk factors for adenocarcinoma of the oesophagus?

Obesity

Gastro-oesophageal reflux (such as Barrett's metaplasia)

9

Where in the oesophagus does squamous cell carcinoma occur?

Proximal and middle third

10

What are risk factors for squamous cell carcinoma of the oesophagus?

Smoking

Alcohol

Low socio-economic status

11

What are some symptoms of oesophageal cancer?

Frequent and persistent hiccups

Acid indigestion, heartburn and reflux

Difficulty when swallowing (dysphagia)

Constant burping, belching and coughing

Pain between the shoulder blades

Weight loss

12

What are very important symptoms for oesophageal acid?

Dysphagia and weight loss

13

What investigations are done for oesophageal cancer?

Endoscopy or contrast swallow

14

Why is endoscopy prefered to contrast swallow for investigating oesophageal cancer?

Can see if is benign or malignant by doing biopsy with endoscopy

15

What must be done once the diagnosis of oesophageal cancer is confirmed?

Stage the tumour

16

What staging is used for oesophageal cancer?

TNM staging

17

Explain the algorithm for staging oesophageal cancer?

1) CT scan of chest and abdomen

2) If metastatic/unfit then no further staging is required and palliative/supportive therapy is given

3) If resectable/fit an EUS is done for T/N staging and a PET CT for M staging

18

For staging, what is done after the CT of the chest/abdomen if the patient is fit?

EUS for T/N staging

PET CT for M staging

19

Why is a PET scan done for M staging?

Metastasis in small number of patients is not picked up by CT scan

20

How is a tumour seen on a CT scan?

Oesophagus should be black due to being full of air, tumour is a different colour

21

What does the T score of a tumour tell us?

How much the tumour has progressed through the mucosa into the muscle wall then otno the surface and perhaps surrounding structures such as lung or pericardium

22

What does the N score of a tumour tell us?

If the cancer has entered the lymph nodes

23

Do node positive or node negative tumours have a worse prognosis?

Node positive

24

What does M staging of a tumour tell us?

If metastasis are present

25

What are common metastasis from oesophageal cancer?

Lungs or liver

26

What are treatment options for oesophageal cancer for people who are metastatic/unfit?

Stenting (allows them to eat)

Palliative radiotherapy (increases length of life)

Palliative chemotherapy (increases length of life)

27

What needs to be considered when giving chemotherapy?

Side effects, sacrificing quality of life for more time

28

What are treatment options for oesophageal cancer for people who are resectable/fit?

Oesophagectomy and chemotherapy

Chemotherapy and radiology if concerns about fitness

29

What is the 5 year survival rate of someone who recieves an oesophagectomy and chemotherapy for oesophageal cancer?

45%

30

What is the 5 year survival rate for someone who recieves chemotherapy and radiotherapy for oesophageal cancer?

30%