Postoperative complications after gastric cancer surgery has their own specificity and complexity, and the strategies for prevention and treatment should be of equal emphasis on both theory and technology. Based on the knowledge and familiarity with different postoperative complications, to efficiently prevent them, it is not only necessary to strengthen the training of acknowledged operative strategy, smooth and precise surgical techniques, but also to address the importance of overall preoperative assessment for patients, to treat the basic diseases, and to improve and correct their general conditions. Combining with the concept and basic protocol of enhanced recovery after surgery (ERAS), it is preferred to work out an individualized perioperative preventing strategy for patients who have high risk factors of specific postoperative complications. After the operation, to guarantee intensive and individual managements for patients, to catch early abnormal signs, then to make early and precise diagnosis, and to do timely response and accurate treatments, including timely and proper re-operations, can improve the efficacy of complications and promote the recovery of patients as soon as possible.
Digestive System Surgical Procedures ; adverse effects ; rehabilitation ; Humans ; Patient Care Planning ; standards ; Perioperative Care ; methods ; standards ; Postoperative Complications ; diagnosis ; prevention & control ; therapy ; Reoperation ; standards ; Stomach Neoplasms ; surgery

A chemopreventive approach to cancers of the upper aerodigestive tract (including those of head and neck and lung) to reduce the incidence and mortality rates for these cancers has become an important strategy because therapies such as surgery, radiation, and chemotherapy have only marginally improved the five-year survival rate over the last two decades. However, chemopreventive trials have been hampered by serious feasibility problems, including high cost, the requirement of large numbers of patients, and long-term follow-up necessary to determine cancer incidence, which served as the study end point. Thus, the use of biomarkers, the identification of which would serve as an intermediate end point of the study has recently emerged as a subject of great interest. To try to understand the process of tumorigenesis from normal tissues through the premalignant tissue stage to malignant lesions, there has recently been a search for genetic and/or phenotypic changes that qualify as candidates for biomarkers. These candidates include genomic markers, certain specific genetic markers (such as oncogenes, growth factors and their receptors, and tumor suppressor genes), cell proliferation markers, and cell differentiation markers. This review covers genomic markers (including micronuclei and specific chromosomal alterations) and specific genetic markers (such as the ras gene family, the myc family, erb B1, int-2/hst-1, and the p53 tumor suppressor gene). As a consequence of genetic alteration, we also reviewed cell proliferation markers such as proliferating cell nuclei antigen (PCNA) and the squamous cell differentiations markers, including keratins, involucrin, and transglutaminase 1. These biomarker candidates are important adjuncts to the development of the new chemopreventive agents and to the rational design of future intervention trials. However, it should be emphasized that these biomarkers must first be validated in clinical trials; only then can they replace cancer incidence as the sole end point in chemoprevention trials.
Chromosome Aberrations ; Digestive System Neoplasms/*diagnosis/prevention & control ; Genetic Markers ; Human ; Respiratory Tract Neoplasms/*diagnosis/prevention & control ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Tumor Markers, Biological/*blood

BACKGROUND: A esophagogastroduodenoscopy is now considered to be one of the essential rnethods for diagnosis of upper gastrointestinal disease. Furthermore early detection of stomach cancer by such a mass screening techique is very important to increase the survival rate. METHODS: A clinical analysis was conducted on 9,137 healthy subjects who had undergone a gastrofiberscopic examination for the secondary prevention, from January 1995 to December 1996, in Kangbuk Samsung hospital. RESULTS: 1) Number of cases with normal finding was 764 (8.4%). 2) The most prevalent disease found was chronic gastritis (82%). The number of cases with superficial gastritis was 64.7%, erosive gastritis 9.0%, atrophic gastritis 6.4% and metaplastic gastritis 1.6%. Atrophic and metaplastic gastritis were more frequent in the older age group. 3) The prevalence of peptic ulcer was 13.9% and duodenal ulcers (8.1%) was more common than gastric ulcers (5.8%, p<0.05) with a male to female ratio of 3.7: 1, and 2.1: 1 respectively. 4) Of the 10 cases with stomach cancer (0.11%), 5 cases (0.055%) were found to be advanced stomach cancer and the other 5 cases (0.055%) were early gastric cancer. The macroscopic type of early gastric cancer was type IIc in 4 cases and type IIb in another case, and 4 cases were limited in mucosa but another was in submucosa. The size of 4 cases were below 1 cm and there was no lymph node metastasis. CONCLUSION: Medically screened subjects were found to have many abnormalities, and therefore, it is recommanded that regular check ups using an endoscopy would be needed for early detection of early gastric cancer regardless of clinical symptoms.
Diagnosis ; Duodenal Ulcer ; Endoscopy ; Endoscopy, Digestive System ; Female ; Gastritis ; Gastritis, Atrophic ; Gastrointestinal Diseases ; Humans ; Lymph Nodes ; Male ; Mass Screening ; Mucous Membrane ; Neoplasm Metastasis ; Peptic Ulcer ; Prevalence ; Secondary Prevention* ; Stomach Neoplasms ; Stomach Ulcer ; Survival Rate