Current and Future Developments in Surgery Volume 2: Oesophago-gastric Surgery

Table of Contents

Chapter 1 Benign Disorders Of The Stomach 

• Dyspepsia
  
• Elizabeth Vaughan And Sami M Shimi
  
• Diagnosis
  
• Management
  
• Gastritis
  
• Chronic Gastritis
  
• Acute Gastritis
  
• Histological Classification
  
• Non-Atrophic H Pylori Gastritis
  
• Atrophic Gastritis
  
• H Pylori Associated Chronic Gastritis
  
• Other Forms Of Gastritis
  
• Chronic Reactive (Chemical) Gastritis
  
• Autoimmune Gastritis
  
• Eosinophilic Gastritis
  
• Lymphocytic Gastritis
  
• Suppurative (Phlegmonous) Gastritis
  
• Aids Gastritis
  
• Granulomatous And Crohn’S Gastritis
  
• Emphysematous Gastritis
  
• Gastritis Cystica Polyposa
  
• Presentation And Clinical Features
  
• Diagnosis
  
• Risk Of Cancer With Gastritis
  
• Medical Management Of Gastritis
  
• Surgical Management Of Gastritis
  
• Roux-En-Y Or Braun Gastrojejunostomy
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction (Braun)
  
• Reconstruction (Roux-En-Y)
  
• Post-Operative Course
  
• Anticipated Complications
  
• De Meester Duodenal Switch Procedure
  
• Dissection
  
• Reconstruction
  
• Peptic Ulceration
  
• Epidemiology
  
• Aetiology
  
• Pathology
  
• Presentation And Clinical Features
  
• Diagnosis
  
• Risk Of Cancer From Peptic Ulceration
  
• Medical Management
  
• Anti-Secretory Agents
  
• Proton Pump Inhibitors (Ppis)
  
• Hydrogen Receptor Antagonists (H2Ras)
  
• Antibiotics
  
• Mucosal Protective Agents
  
• Complications Of Peptic Ulcer Disease And Their Management
  
• Surgical Control Of Bleeding Peptic Ulcer
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction
  
• Post-Operative Course
  
• Anticipated Complications
  
• Surgical Repair Of Perforated Peptic Ulcer
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction
  
• Post-Operative Course
  
• Anticipated Complications
  
• Gastric Outlet Obstruction
  
• Epidemiology
  
• Aetiology
  
• Pathophysiology
  
• Presentation And Clinical Features
  
• Diagnosis
  
• Medical Management
  
• Endoscopic Therapy
  
• Pneumatic Balloon Dilatation
  
• Endoscopic Stenting
  
• Surgical Management
  
• Surgical Procedures
  
• Pyloroplasty
  
• Heineke-Mikulicz Pyloroplasty
  
• Finney’S Pyloroplasty
  
• Jaboulay Pyloroplasty
  
• Antrectomy
  
• Access
  
• Exploration
  
• Dissection
  
• Resection
  
• Reconstruction
  
• Anticipated Complications
  
• Upper Gi Bleeding (Non-Variceal)
  
• Evaluation And Management Of The Bleeding Patient
  
• Bleeding Lesions In The Stomach
  
• Mallory-Weiss Tears
  
• Gastric Antral Vascular Ectasia (Watermelon Stomach Or Gave)
  
• Dieulafoy Lesion (Dl)
  
• Hereditary Haemorrhagic Telangiectasia (Hht) (Rendu-Osler-Weber Syndrome)
  
• Gastric Haemangioma
  
• Portal Hypertensive Gastropathy (Phg)
  
• Acute Gastric Dilatation
  
• Presentation And Clinical Features
  
• Complications
  
• Pathophysiology
  
• Aetiology
  
• Medical Management
  
• Surgical Treatment
  
• Gastriv Volvulus
  
• Presentation And Clinical Features
  
• Epidemiology
  
• Diagnosis
  
• Aetiology And Pathophysiology
  
• Complications
  
• Management Of Gastric Volvulus
  
• Gastropexy
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 2 Oesophago-Gastric Motility Disorders

• Maria Coats
  
• Oesophageal Motility Disorders
  
• Presentation
  
• Investigations Of Oesophageal Motility Disorders
  
• Oesophageal Manometry
  
• Conventional Water-Perfused Catheter Manometry
  
• Solid-State Catheter Manometry
  
• High Resolution Manometry (Hrm)
  
• Contrast Radiology
  
• Fluoroscopy/Video-Radiology
  
• Ct Scanning
  
• Radio Isotope Studies
  
• Endoscopy
  
• Primary Oesophageal Motility Disorders
  
• Achalasia
  
• Clinical Features
  
• Investigations
  
• Upper Gastro-Intestinal Endoscopy
  
• Manometry Studies
  
• Management
  
• Pharmacological Therapy
  
• Endoscopic Treatments
  
• Surgery
  
• Heller’S Myotomy Technical Steps
  
• Recent Advances And Emerging Therapies
  
• Diffuse Oesophageal Spasm
  
• Nutcracker Oesophagus
  
• Vigorous Achalasia
  
• Non-Specific Oesophageal Motility Disorders
  
• Chagas’ Disease
  
• Secondary Oesophageal Motility Disorders
  
• Systemic Sclerosis
  
• Gastroparesis
  
• Presentation And Clinical Features
  
• Diagnosis
  
• Pathophysiology
  
• Aetiology
  
• Idiopathic Gastroparesis
  
• Diabetic Gastroparesis
  
• Post-Surgical Gastroparesis
  
• Refractory Gastroparesis
  
• Complications
  
• Medical Management Of Gastroparesis
  
• Endoscopy And Gastroparesis
  
• Surgery And Gastroparesis
  
• Gastric Electrical Stimulation
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 3 Oesophageal Neoplasms

• Prdeep Patil
  
• And Sami M Shimi
  
• General Features Of Oesophageal Tumours
  
• Aetiology And Risk Factors
  
• Presentation
  
• Diagnosis
  
• Pathology, Histology And Bio-Markers
  
• Benign Tumours
  
• Malignant Oesophageal Neoplasms
  
• Histology
  
• Squamous Cell Carcinoma (Oscc)
  
• Adenocarcinoma (Oac)
  
• Squamous Cell Variants
  
• Adenoma Carcinoma Variants
  
• Other Tumours
  
• Tumour Biomarkers
  
• Immunohistochemical Biomarkers
  
• Blood-Based Biomarkers
  
• Mrna-Based Biomarkers
  
• Gene Expression Profiling Biomarkers
  
• Staging Of Oesophageal Cancer
  
• Management Of Oesophageal Cancer
  
• General Considerations
  
• Nutrition
  
• Physical Fitness
  
• Respiratory And Cardiovascular Optimisation
  
• Anatomical Considerations
  
• Treatment Strategy
  
• Surgical Resection
  
• (A) Tumours Of The Cervical Oesophagus
  
• (B) Tumours Of The Thoracic Oesophagus
  
• (C) Tumours Of The Oesophago-Gastric Junction
  
• Lymphadenectomy
  
• Reconstruction
  
• Technical Steps In Oesophagectomy
  
• Cervical Stage
  
• Abdominal Stage
  
• Right Posterolateral Thoracotomy
  
• Oncological Management
  
• Radiotherapy
  
• Chemotherapy
  
• Multi-Modality Treatment
  
• Palliation Of Oesophageal Cancer
  
• Surgical Bypass
  
• Laser Canalisation
  
• Electrocoagulation
  
• Ethanol Injection
  
• Intubation
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 4 Gastric Neoplasms

• Tumours Of The Stomach
  
• Benign Tumours Of The Stomach
  
• Malignant Tumours Of The Stomach
  
• Gastric Adenocarcinoma
  
• Presentation And Clinical Features
  
• Diagnosis Of Gastric Cancer
  
• Staging Of Gastric Cancer
  
• Serological Biomarkers Of Gastric Cancer
  
• Classification Of Gastric Cancer
  
• Histology
  
• Spread Of Gastric Cancer
  
• Direct Extension
  
• Lymphatic Spread
  
• Peritoneal Spread
  
• Haematogenous Spread
  
• Early Gastric Cancer
  
• Endoscopic Diagnosis
  
• White Light Endoscopy
  
• Chromoendoscopy
  
• Narrow Band Imaging
  
• Endoscopic Ultrasonography
  
• Management Of Early Gastric Cancer
  
• Endoscopic Therapy
  
• Surgical Management Of Egc
  
• Advanced Gastric Cancer
  
• Management Of Advanced Gastric Cancer
  
• Extent Of Resection
  
• Lymphadenectomy
  
• Reconstruction After Gastric Resection
  
• Gastrectomy
  
• The Surgical Procedure
  
• Key Steps:
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction (Rou-En-Y With A Pouch)
  
• Post-Operative Course
  
• Anticipated Complications
  
• Laparoscopic Gastrectomy
  
• Oncological Management Of Gastric Cancer
  
• Palliation Of Advanced Gastric Cancer
  
• Surgical Palliation
  
• Palliative Surgical Bypass
  
• Stenting Of Distal Gastric Cancer
  
• Palliative Gastro-Enterostomy (Ge)
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction (Omega Loop)
  
• Post-Operative Course
  
• Anticipated Complications
  
• Surgical Insertion Of Feeding Jejunostomy
  
• Access
  
• Exploration
  
• Dissection
  
• Reconstruction
  
• Post-Operative Course
  
• Anticipated Complications
  
• Prognosis Of Gastric Cancer
  
• Pattern Of Relapse
  
• Supportive Care
  
• Gastro-Intestinal Stromal Tumours
  
• Presentation
  
• Pathology And Molecular Genetics
  
• Evaluation And Staging
  
• Management
  
• Adjuvant/ Neo-Adjuvant Therapy
  
• Prognosis
  
• Follow-Up And Monitoring
  
• Wedge Resection Of Gists
  
• Gastric Neuronedocrine Tumours
  
• Evaluation And Staging
  
• Management
  
• Gastric Lymphoma
  
• Presentation
  
• Management
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 5 Oncological Management Of Oesophageal And Gastric

• Cancer
  
• Russell Petty
  
• And Asa Dahle-Smith
  
• Rationale And Assessment
  
• Rationale
  
• Assessment Of Patients For Oncological Management
  
• Early Stage Oesophageal Cancer
  
• Pre-Operative Treatment
  
• Neo-Adjuvant Chemoradiotherapy (Na Crt)
  
• Neoadjuvant Chemotherapy (Nac)
  
• Neoadjuvant Chemoradiotherapy Or Chemotherapy?
  
• Peri-Operative Chemotherapy
  
• Definitive Chemo-Radiotherapy (Dcrt)
  
• Early Stage Gastric Cancer
  
• Peri-Operative Treatment
  
• Adjuvant Treatment
  
• Adjuvant Chemotherapy
  
• Adjuvant Chemoradiotherapy
  
• Perioperative Chemotherapy, Adjuvant Chemotherapy Or Adjuvant Crt For Gastric
  
• Cancer?
  
• Oncological Management Of Advanced Oesophageal And Gastric
  
• Cancer
  
• Systemic Palliative Therapy In Advanced Oesophageal And Gastric Cancer
  
• Emerging Targeted Therapies And Molecular Sub-Classification
  
• Rare Oesophageal And Gastric Tumours
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 6 Endoscopic Therapeutic Procedures

• Hugh Dalziel
  
• And Sami M Shimi
  
• Endoscopic Dissection And Resection
  
• Historical Background
  
• Endoscopic Mucosal Resection (Emr)
  
• Specimen Preparation
  
• Methodology Of Esd
  
• Indications For Esd
  
• Early Gastric Cancer
  
• Early Oesophageal Cancer
  
• Nodular Hgd
  
• Endoscopic Full-Thickness Resection (Eftr)
  
• Preoperative Evaluation For Candidates Of Er
  
• Pathological Evaluation Of The Removed Specimen
  
• Outcome Results And Complications Of Esd
  
• Management After Esd
  
• Future Perspectives
  
• Endoscopic Mucosal Ablation
  
• Photo-Dynamic Therapy (Pdt)
  
• Nd:Yag And Ktp Laser-Derived Thermal Therapies
  
• Cryotherapy
  
• Argon Plasma Coagulation (Apc)
  
• Radio-Frequency Ablation (Rfa)
  
• Er And Mucosal Ablation
  
• Endoscopic Haemostasis
  
• Introduction
  
• Risk Stratification Scores
  
• Endoscopic Therapy
  
• Endoscopic Risk Stratification
  
• Types Of Endoscopic Therapy
  
• Injection Therapy
  
• Thermal Devices
  
• Coagulation Forceps
  
• Mechanical Devices (Clips)
  
• Through The Scope Clips
  
• Over The Scope Clips
  
• Mechanical Ligation
  
• Detachable Snares
  
• Band Ligation
  
• Combined Therapy
  
• Topical Haemostatic Agents
  
• Removable Covered Stents
  
• Bleeding Lesions In The Oesophagus And Stomach
  
• Peptic Ulcer Upper Gi Bleeding
  
• Mallory-Weiss Syndrome
  
• Dieulafoy's Lesions
  
• Tumours
  
• Gastric Antral Vascular Ectasia
  
• Angiectasia
  
• Bleeding Related To Esd
  
• Bleeding Related To Endoscopic Mucosal Resection (Emr)
  
• Bleeding Lesions Related To Portal Hypertension
  
• Varices
  
• Gastro-Oesophageal Varices
  
• Radiological Methods Of Haemostasis
  
• Types Of Procedure
  
• Predictors Of Outcome
  
• Endoscopic Stenting Of Obstructing Lesions
  
• Indications And Contraindications
  
• Pre-Stenting Patient Preparation
  
• Techniques Of Oesophageal Stenting
  
• Endoscopic Insertion Of Stent
  
• Radiological Insertion Of Stent
  
• Combined Method Of Stent Insertion
  
• Stent Options
  
• Uncovered Vs Covered Stents
  
• After Care And Nutrition
  
• Stenting Across Og Junction
  
• Clinical Results
  
• Complications
  
• Stenting For Malignant Gastric Outlet Obstruction (Mgoo)
  
• Technical And Clinical Success Of Stenting Mgoo
  
• Stent Dysfunction
  
• Perforation And Bleeding
  
• Stent Patency And Overall Survival
  
• Sems Stenting Procedure
  
• Evaluation Of Subjective Symptoms After Sems
  
• Future Advances In Oesophageal Stenting
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 7 Bariatric Anaesthesia

• Shaun Mcleod
  
• Anaesthesia In Bariatric Surgery
  
• Introduction
  
• Pathophysiology Of Obesity
  
• Anti-Obesity Surgery
  
• Anaesthetic Considerations
  
• Pre-Operative Optimisation
  
• Obstructive Sleep Apnoea (Osa)
  
• Obesity Hypoventilation Syndrome
  
• Respiratory Function
  
• Cardiovascular Factors
  
• Endocrine Factors
  
• Pharmacology Of Anaesthetic Agents In Obesity
  
• Pre-Operative Preparation
  
• Airway Assessment
  
• Respiratory System
  
• Cardiovascular System
  
• Glucose Control
  
• Nutritional State
  
• Intra-Operative Anesthetic Management
  
• Positioning
  
• Thrombo-Embolism Prophylaxis
  
• Antibiotic Prophylaxis
  
• Standard Monitoring
  
• Venous Access
  
• Pre-Oxygenation
  
• Induction Of Anaesthesia
  
• Intubation
  
• Maintenance Of Anaesthesia
  
• Multimodal Analgesia
  
• Reversal Of Anaesthesia
  
• Post-Anaesthetic Management
  
• Post-Operative Environment
  
• Supplementary Oxygen
  
• Post-Operative Analgesia
  
• Thrombo-Embolism Prophylaxis
  
• Mobilisation
  
• Fluids And Diet Reintroduction
  
• Hospital Discharge
  
• Consent For Publication
  
• Acknowledgement
  
• Conflict Of Interest
  
• References
  

Chapter 8 Bariatric And Metabolic Surgery

• Jamie Young
  
• Global Obesity
  
• Background
  
• Aetiology And Epidemiology
  
• Definition Of Obesity
  
• Consequences Of Obesity
  
• Prevention Of Obesity
  
• Management Of Obesity
  
• Multidisciplinary Team
  
• Non-Surgical Management
  
• Dietary Management
  
• Very Low Calorie Diets
  
• Exercise
  
• Psychology
  
• Pharmacology
  
• Outcomes Of Non-Surgical Treatment
  
• Surgical Management
  
• Pathophysiology Of Anti-Obesity Surgery
  
• Bariatric Surgery And Pregnancy
  
• Preoperative Assessment
  
• Anaesthetic Considerations
  
• Post-Operative Care
  
• Operative Considerations
  
• Follow Up After Bariatric Surgery
  
• Audit / Outcomes
  
• Surgical Procedures
  
• Choice Of Procedure
  
• Intra-Gastric Balloon
  
• Vertical Banded Gastroplasty
  
• Duodeno-Jejunal Bypass Sleeve
  
• Gastric Bands
  
• Sleeve Gastric Resection
  
• Roux-En-Y Gastric Bypass
  
• Loop Gastric Bypass
  
• Bilio-Pancreatic Bypass With Duodenal Switch (Bpd/Ds)
  
• Novel Procedures
  
• Re-Do Bariatric Surgery
  

Author

• Sami M. Shimi