[AC] General Upper Abdominal Surgery

Question 1

A Gastrectomy is

Answer 1

The removal of the stomach

Question 2

A oesophagogastrectomy is

Answer 2

Removal of the lower part of the oesophagus and entire stomach with oesophago - jejunostomy via laparotomy or thoracoabdominal incision

Question 3

A bowel resection is a surgical procedure in which

Answer 3

A part of the large or small intestine is removed.

Question 4

What is an abdominal aortic aneurysm repair?

Answer 4

A procedure used to treat an aneurysm (abnormal enlargement) of the abdominal aorta.

Question 5

What is anaemia? Why does this occur from surgery?

Answer 5

Decrease in the number of red blood cells.

Could because of blood/fluid loss in theatre, in which can blood transfusion can be used to restore Hb levels in severe anaemic patients

Question 6

A central venous catheter (or ‘central line’) is usually placed in surgery and is a ____

Answer 6

catheter placed into a large vein in the neck (internal jugular vein), chest (subclavian or axillary) or groin (femoral). It used to administer medication or fluids, obtain blood tests (specifically the ‘central venous oxygen saturation’) and measure central venous pressure

Question 7

Some risk factors associated with oesophageal cancer?

Answer 7

Heavy alcohol use in conjunction with cigarette smoking or chewing tobacco

Some research of a genetic component

Question 8

What is the most common initial symptom of oesophageal cancer?

Answer 8

Dysphagia (difficulty swallowing) but usually occurs in late stage oesophageal cancer

Question 9

The most common surgical procedures for oesophageal cancer are:

Answer 9

transhiatal (trans-hiatal) esophagectomy and transthoracic esophagectomy

Question 10

Transhiatal Esophagectomy involves

Answer 10

Both an abdominal incision and a cervical (neck) incision. The thoracic cavity is not opened (thus less likely of PPC’s)

Question 11

Transthoracic esophagectomy involves an

Answer 11

abdominal incision and a thoracotomy. The mid and lower parts of the oesophagus are removed along with the upper part of the stomach

Question 12

The choice of what kind of operation the surgeon does for oesophageal cancer depends on

Answer 12

the location of the tumour; the patient’s pulmonary function, and the surgeon’s experience and preference

Question 13

After esophagectomy, patients go to an

Answer 13

intensive care unit for 24 to 48 hours. They are usually intubated and have multiple drains and tubes.

Question 14

Initial pain management of esophagectomy may include

Answer 14

epidurally, patient-controlled analgesia with morphine

Question 15

Patients are nil by mouth for 5-7 days following esophagectomy therefore medication is provided via

Answer 15

intraveous or epidurally

Question 16

We can initiate coughing, deep breathing, incentive spirometery after an esophagectomy patient has been

Answer 16

extubated

Question 17

Early mobilisation for a patient after esophagectomy will reduce the pulmonary risk of

Answer 17

atelectasis, a precursor to pneumonia

Question 18

We should check chest tube sites for

Answer 18

Drainage, and ensure the chest tube dressing is clean, dry and intact

Question 19

Depending on the type of surgery, a chest tube may be in place. For patients with chest tubes we should assess the

Answer 19

drainage every shift. Expect no more than 100 to 200 mL/h on the first day. Drainage should decrease gradually

Question 20

Generally, all patients have a nasogastric tube after esophagectomy. We should not

Answer 20

move, manipulate or irrigate the nasogastric tube. We should notify a physician immediately if the tube becomes dislodged or stops functioning properly

Question 21

Early mobilisation as well as early leg and ankle exercises can prevent DVTs. For esophagectomy patients early mobilisation on the first day can include

Answer 21

Getting them out of bed to a chair

Question 22

During surgery of esophagectomy a feeding jejunostomy tube is placed and is removed depending on patients progress. It is inserted ..

Answer 22

Through the abdomen and into the jejunum