Esophageal and Upper Gastrointestinal Surgery 食管腸胃外科

STAFF

Professor Simon Ying Kit LAW Division Chief, Professor, Honorary Consultant MS (HK), MA (Cantab), MBBChir (Cantab), FRCS (Edin), FCSHK, FHKAM, FACS e-mail: slaw@hkucc.hku.hk	Professor Kent Man CHU Deputy Division Chief, Professor, Honorary Consultant MBBS (HK), MS (HK), FRCS (Edin), FCSHK, FCSHK, FHKAM, FACS e-mail: chukm@hkucc.hku.hk
Prof. Simon Law (Division Chief)	Prof. KM Chu (Deputy Division Chief)

• Dr. Daniel King Hung TONG
  Associate Consultant
  MBBS (HK), MS (HK), FRACS, FCSHK, FHKAM (Surg)
  

• Dr. Siu Yin CHAN
  Associate Consultant
  MBBS (HK), FRCS (Edin), FCSHK, FHKAM (Surg)
  

• Dr. Kam Ho WONG
  Specialist
  MBBS (HK), FRCS (Edin), FCSHK, FHKAM (Surg)
  

Research Staff

• Dr. Yvonne CHUNG
  Research Associate
  Bsc (Hons), PhD

• Ms. Pearl YUN
  Research Assistant
  BSc

ACTIVITIES AND SERVICES

The Division of Esophageal and Upper Gastrointestinal Surgery is dedicated to achieve the highest standard of clinical care to patients suffering from disorders of the esophagus, stomach, and small bowel. Specialist services include the assessment and treatment of patients with swallowing problems, esophageal motility diseases, gastroesophageal reflux disease, heartburn and regurgitation symptoms, benign and malignant tumors of the esophagus, stomach, duodenum and small bowel, ingested foreign bodies, gastrointestinal bleeding, peptic ulcer diseases and their complications, other emergencies such as esophageal perforation and caustic substance ingestion, and metabolic and bariatric surgery for morbid obesity.

In addition to surgery, diagnostic and therapeutic procedures are regularly performed, which consist of esophago-gastro-duodenoscopy, small bowel enteroscopy, capsule endoscopy, bronchoscopy, dilatation for strictures from various aetiologies, endoscopic ultrasound for the esophagus and stomach, haemostatic procedures, balloon dilatation for patients with achalasia, insertion of self-expanding metallic stents for palliation of patients with upper gastrointestinal tract obstruction from cancers, endoscopic resections of early esophageal and gastric tumors, and laser therapy. Specialized diagnostic tools also involve esophageal manometry and 24 hour pH monitoring, and isotope ratio mass spectrometer for C13-urea breath test for helicobacter pylori. Outpatient consultations are provided at S4 of the specialist outpatient block at Queen Mary Hospital. Private patients are seen at The University of Hong Kong Department of Surgery Private Clinic at Room 201, Professorial Block, Queen Mary Hospital.

Strengths and Developments

The Division is internationally renowned for its management of patients suffering from esophageal, gastric and other upper gastrointestinal disorders, especially esophageal and gastric cancer. It has established itself as a major referral centre not just in Hong Kong, but in the Asia-Pacific region. Many referrals come from abroad for surgery performed at the Queen Mary Hospital every year. The Division has one of the lowest morbidity and mortality rates after esophagectomy in the world. Esophagectomy is a procedure with a definite volume-outcome relationship, and being a high-volume centre has made this possible. The results are published regularly in high impact-factor international journals. Recent developments in surgery include the performance of extended lymph node dissection for esophageal and gastric cancers, and the pioneering of minimally invasive surgical techniques; examples of which include thoracoscopic and laparoscopic esophagectomy, laparoscopic gastrectomy, laparoscopic or thoracoscopic approaches for peptic ulcer diseases, staging laparoscopy and laparoscopic ultrasonography for gastric cancer, laparoscopic and thoracoscopic resection of benign esophageal and gastric tumors, esophageal myotomy for achalasia, and laparoscopic fundoplication for gastroesophageal reflux disease. State-of-the-art surgical equipments are available for performing minimally invasive surgery.

A multidisciplinary approach is used to treat esophageal and gastric cancers. In collaboration with the Department of Clinical Oncology, many selected patients undergo neoadjuvant chemotherapy and / or radiotherapy, as well as postoperative therapies. This has made downstaging of many patients with advanced tumors possible, so that more curative resections can be performed. Together with better results of surgery, the overall survival of patients with esophago-gastric malignancies has improved over the years.

Research

The Division is active both in clinical and laboratory basic research, the results of which are published regularly in high impact factor international journals, and also presented in local and international meetings. Recent examples of published and on-going projects include:

• Studies on factors affecting morbidity and mortality after esophagectomy
• Use of minimally invasive techniques in esophagectomy
• Implications of neoadjuvant chemoradiation on staging of esophageal cancer
• Use of Cox-2 inhibitor to enhance response from chemoradiation for esophageal cancer
• Influence of technical complications on long-term prognosis after esophagectomy
• Use of self-expanding metallic stents in palliation of patients with esophageal cancer
• Positron-Emission-Tomography scan in staging for esophageal cancer and assessment of response after neoadjuvant chemoradiation therapy
• Endoscopic ultrasound in staging esophageal and gastric cancer
• Minimally invasive surgery in treating achalasia
• Molecular, genomics and proteomics approaches in study of esophageal, gastric cancer, gastrointestinal stroma tumors and lymphoma
• Establishment of novel esophageal cancer cell lines
• Gastroesophageal reflux disease
• Biomarkers and prognostic significance in esophageal cancer
• Foreign body ingestion
• Peptic ulcer diseases and their complications
• Helicobacter pylori infection
• Surgical education

Collaborations

The Division is active in its collaborations, both in clinical management of patients and in research. It works together with the Divisions of Head and Neck Surgery and Cardiothoracic Surgery regularly in management of patients with complex problems involving these specialties. It forms a multidisciplinary team with the Department of Clinical Oncology in treating patients with esophageal and gastric cancer. Working also in partnership with the Division of Gastroenterology and Hepatology of the Department of Medicine, many patients with esophageal motility disorders, gastroesophageal reflux disease, peptic ulcer disease, and other functional problems of the upper gastrointestinal tract, are managed.

The Division is also active in collaboration with other Universities in Hong Kong as well as institutions in USA, Europe and Asia to further research in esophageal and upper gastrointestinal diseases.