The Department is offering comprehensive care along with the Medical oncologist to patients requiring treatment for gastro-intenstinal malignancies (Cancer) by Laparoscopy . Laparoscopic procedures offers benefits like quicker recovery, shorter hospital stays, less bleeding therefore decreased usage of blood and blood products, and significantly reduced risk of infection and recurrence. Patients receive state-of-the art multidisciplinary care from the team working in collaboration with other specialists . Most common procedures performed in the Department are :
- Esophagectomy (Cancer of the esophagus)
- Whipples Procedure (Pancreatic cancer)
- Radical Gastrectomy
- Benign and Malignant condition of small and large intestine
- Rectal cancer
- Liver Resections
Gastroesophageal reflux disease (GERD) is a condition in which damage to the esophageal, oropharyngeal and laryngeal issue occurs due to excessive backwashing of gastrìc contents into the esophagus.
The typical symptoms of GERD are burning in the chest (heartburn} and regurgitation of sour or bitter liquid, sometimes mixed with food, io the throat or mouth. Although not everyone has these symptoms, they are so indicative of reflux that testing is not usually necessary. Other relatively common symptoms include chest pain, which may stimulate cardiac disease, and the feeling of food Micking in the esophagus. less often GERD may cause throat burning, coughing, asthma, or recurrent pulmonary infections (recurrent bronchitis or asprahon pneumonia)
Polls of normal individuals reveal a large percentage of the population has occasional symptoms of heartburn. Tesis of acid reflux using pH probes placed in the esophagus suggest that a limited amount of reflux occurs daily in the majority of individuals (physiologic reflux}. Reflux is only considered a disease when excessive amounts of reflux occur (pathologic reflux) causing frequent symptoms or tissue damage. The strength of the lower esophageal sphincier (LES) and the normal anatomic configuration of the function of the esophagus and stomach. LES strength can be measured by esophageal manometry (pressure siudies). The esophagus usually joins the stomach within the abdomen at an abrupt angle. When the esophagogasfric junction IS in the chest rather than the abdomen, a hiaial hernia is said to be present. A low LES pressure or a hiatal hernia predisposes individuals to abnormal amount of reflux. Pathologic reflux IS more likely when both abnormalities occurs in the same individual.
GERD can be treated in several ways. The first approach is dietary and lifestyle modifications, e.g., decreasing the intake of foods that increase gastric acidity or reduce the pressure that the muscle at the lower end of the esophagus (eg: caffeinated and decaffeinated foods, chocolate, peppermint and spearmint}. Coffee, alcohol and acidic liquids affect esophageal peristalsis, and fatty foods should be avoided. Large meals increase gastric pressure and therefore increase reflux. Smoking affects esophageal motor function, stimulates acid secretion and delays gastric emptying, potentiating reflux. Air swallowed while smoking increases the need for belching and therefore increases reflux. Lying down after eating should be avoided to keep the food in the stomach from refluxing into the esophagus. The head of the bed should be elevated at night to prevent the same type of reflux. Weight reduction is also recommended for those patients who are markedly overweight to lessen the frequency of reflux. New endoscopic techniques that are being developed may be useful to treat refractory reflux.Drug therapy is used in combination With: lifestyle changes. Acid-suppressing agents and drugs that enhance upper gastrointestinal motility are often prescribed.
Surgery is the other choice to manage GERD.The mode of treatment is used primarily if the patient is unwilling or unable to cope with lifestyle changes necessary for management of reflux disease.A Nissen fundoplication is the most common procedure performed.