Current Updates and Advances in the Diagnosis and Surgical Management of Oesophageal Cancers: An Overview for FRCS (Gen Surg)
The incidence of oesophageal cancers, affecting half a million people annually worldwide, is rising rapidly. It is the sixth leading cause of cancer-related mortality. Although the overall five-year survival has increased from 4% in the 1970s to about 15 to 20% currently, oesophageal cancer remains a great challenge to treat as the clinical presentation is often late and diagnosis is made at advanced stages. The two key histological types -adenocarcinoma and squamous cell carcinoma - differ significantly in their fundamental patterns of incidence and aetiological factors. The management requires an MDT approach, an assessment of the patient's fitness (for surgery or chemotherapy), and surgery, chemotherapy or radiotherapy, a combination of the three or palliation in cases of metastasis, disseminated disease or recurrence. Locally advanced disease without signs of distant metastases is treated with an intention to cure. This talk, by Mr Christopher Peters, Consultant UGI Surgeon with specialist interest in oesophageal and gastric surgery at the Imperial College NHS Trust, will provide an overview of this topic and address the current advances and updates in the management of oesophageal cancers.
Mr Christopher Peters, BSc, MBChB, FRCS (General Surgery), PhD
Consultant in Upper Gastrointestinal and General Surgery
Imperial College Healthcare NHS Trust (St Mary's and the Hammersmith Hospitals), London and The Harley Street Clinic
Honorary Clinical Senior Lecturer, Imperial College London
Update on Current and Novel Oral Anti-Coagulants and Anti-Platelets in Dental Extractions: Precautions, Management and Practical Tips
Post-extraction bleeding can lead to significant haemodynamic compromise and morbidity. The complications, occasionally, may even be life-threatening. A variety of anti-coagulants and anti-platelets are currently used in medicine to treat conditions such as atrial fibrillation, cardiac failure, ischaemic stroke, deep venous thrombosis, pulmonary embolism, and peripheral arterial disease. They are also indicated in patients with mechanical heart valves, cancer or gross obesity undergoing surgery. This talk, delivered by both an experienced dental surgeon and a physician, provides an overview of the anti-coagulants (e.g., warfarin, heparin, enoxaparin, dabigatran and rivaroxaban) and anti-platelets (e.g., aspirin and clopidogrel) that are currently used, the types and causes of post-extraction bleeding, haemostatic agents that are currently available, and the recommended guidelines for the management of patients who take these drugs and are undergoing dental extractions.
Dr V. Murugaraj, BDS, MFDS RCS (Eng), FFD RCSI (Ire) Oral Surgery with Oral Medicine
Specialty Doctor in Oral and Maxillofacial Surgery
Royal Berkshire Hospital, Reading