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BRUCE MILLAR CASE STUDY

CONSULTANT AND PROCEDURE

MR JAMES GOSSAGE – CONSULTANT GENERAL SURGEON

MR ANDREW DAVIES – CONSULTANT GENERAL SURGEON

OESOPHAGECTOMY OPERATION

Name: Bruce Millar

Age: 57

Procedure: Oesophagectomy operation

The patient, a 57-year-old male, had always led a healthy

lifestyle with a good diet and exercise, and had no previous

type of cancer. Despite visiting two GPs for their opinion on

his symptoms, and being told that his condition was nothing

sinister, the patient knew something was wrong.

He was experiencing dysphagia and food sticking in his

oesophagus as he tried to swallow. The patient’s symptoms

became aggravated, with worsening dysphagia and rectal

bleeding, but he had been told on several visits to a GP that it

was indigestion. Unbeknown to him, dif culty with swallowing

is a common rst symptom of oesophageal cancer, caused

by the tumour narrowing the passage of the oesophagus.

Constantly feeling unwell and being a husband and father

to a young family of three, the patient decided to take further

action. The patient bene tted from private healthcare

insurance and asked to be referred to a specialist.

After the specialist performed a scan and an endoscopy,

the diagnosis was cancer of the oesophagus. The patient

was told that the prognosis was dependent on the size and

location of the tumour; if the tumour was advanced and

inoperable, he was told his prognosis was less than a year.

It was a horrendous shock and left the patient devastated at

the thought of what could happen, especially as he thought

it may be an ulcer and had never considered cancer.

The patient was then referred to Mr James Gossage at

London Bridge Hospital, who con rmed it was good news

and the cancer was operable. After further scans to locate

the tumour, in the lower oesophagus, and three months of

chemotherapy, the last scan showed the tumour had shrunk

considerably. Mr Gossage and Mr Davies then performed

surgery on the patient under general anaesthetic to remove

the affected part of the stomach, nearly 2/3 of the whole

stomach, and the oesophagus. The operation, called an

Oesophagectomy, involved Mr Gossage pulling the stomach

up into the chest to use it to replace the oesophagus. The

recovery time was fourteen days, spent in hospital following

the surgery.

The patient is extremely grateful for the work of Mr

Gossage and Mr Davies, and for being diagnosed early

enough at London Bridge Hospital to remove the cancer

before it had spread or grown. There was no need for

chemotherapy and he is now back at work. He is having

some dif culties adjusting to not being able to eat certain

foods or big portions, but otherwise the patient is feeling

healthy and happy.

Mr James Gossage

Consultant Upper

GI Surgeon

Mr James Gossage is a Consultant

Upper GI Surgeon at Guy’s and

St Thomas’ Hospital, specialising

in oesophago-gastric cancer

and benign disease of the upper

digestive tract. Together with

Mr Andrew Davies, he runs the

London Surgical Group, which

offers clinic availability at London

Bridge Hospital and the City of

London Medical Centre.

The group has expertise

in advanced laparoscopic

surgery including laparoscopic

cardiomyotomy, paraoesophageal

hernia repair, GIST resection and

both revisional and primary anti-

reflux surgery. They perform both

diagnostic and therapeutic upper

GI endoscopy and offer a wide

range of general surgical and day

case procedures, including open/

laparoscopic hernia repair,

complex incisional hernia repairs

and cholecystectomy.

Oesophageal cancer

NINE

Oesophageal cancer