Nodal disease outside the area of resection for esophageal cancer
(supraclavicular or celiac nodes) is what?
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adenocarcinoma, duodenum
bradykinin, 5 HIAA breakdown
TX: Whipple if 2nd protsion or
product
resection and LAD
, thoracodorsal, Thoracodorsal artery A contraindication to
supplies lat muscle esophagectomy
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2 of 128
Term
What are common complications associated with removal of the
terminal ileum
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Megaloblastic anemia from decreased B12 uptake
Diarrhea/Steathorrea--decreased bile uptake--osmotic diarrhea
Ca oxalate kidney stones--oxalate binds to calcium secondary to increase
intraluminal fat fat binds Ca+ and oxalate gets absorbed in colon
adenomas (duodenum, bleeding and obstruction, treat with resection can be
done with endoscope
Peutz Jeghers Syndrome-AD, hamartomas, mucocutaneous melanotic skin, can
have extraintestinal malginancies **Breast cancer
1-rest
2-accelerationg and gallblader contraction
3-peristalsis
4-deceleration
In young patients who you want to preserve stomach function in
after an esophagectomy what approach can be taken
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Colonic- 3 anastomisis
long thoracic, lateral thoracic artery
required, blood supply is
supplies serratus anterior
based on the marginal artery,
when they have liver metastasis
thoracodorsal, Thoracodorsal artery --can also get asthma type
supplies lat muscle symptoms and right heart lesions
from bradykinin
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, 4 of 128
Term
What are signs of unresectable esophageal cancer, and their
associate area of invasion
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Chylothorax —> high lymphocytes and TAGS, NPO, TPN, short chain FA, treat for 1
week or if >2L a day than thoracic duct ligation
Stricture —> most can be dilated
Hoarseness —> RL nerve
Horner's syndrome —> brachial plexus
Phrenic Nerve Invasion
Malignant pleural effusion or fistula
Invasion of another structure (airway, vertebra, lung)
Transhiatal approach, abdominal and neck incisions, may have increased
mortality from esophageal leaks with cervical anastomosis
Ivor Lewis- abdominal incision, and right thoracotomy, intrathoracic anastomsis
3 Hole esophagectomy- abdominal, thoracic, and cervical anastomosais
NEED PYLOROMYOTOMY with these procedures
1-rest
2-accelerationg and gallblader contraction
3-peristalsis
4-deceleration
Motilin acts on phase 3 peristalsis
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