Gastric cancer is one of the most serious health problems in China. The overall survival rate after surgical treatment has increased and the rate of postoperative complication has decreased. These improvements are due to the introduction of more radical surgical techniques, early detection, and the improvement of anesthesia, perioperative care, and nutritional support. The aim of this article is to introduce the general perioperative management of patients with gastric cancer. Good perioperative management of gastric cancer contributes to the improvement of surgical outcomes. There are several controversial issues in the general perioperative management of gastric cancer, such as gastric tube decompression and nutritional support.
Humans ; Perioperative Care ; methods ; Stomach Neoplasms ; surgery

The author raised that the orientation of peri-operative integrative medicine studies as: Correct surgical decision-making is the prerequisite for successful surgery, the skilled surgical technique is the key for successful operation. At the same time, considerate and appropriate peri-operative management is the guarantee for the success of surgery. Consequently, quick recovery is the core concept of peri-operative integrative medicine studies. Its academic value and practical significance lie in that it can accelerate the improvement of surgical skills, optimize various effective measures to improve the overall efficacy, promote discipline construction and personnel training to improve academic levels, promote the development of Chinese medicine and accelerate its internationalization.
Humans ; Integrative Medicine ; Perioperative Care ; methods ; Rehabilitation ; methods

Humans ; Monitoring, Intraoperative ; methods ; trends ; Perioperative Care ; methods ; trends

Fluid therapy is one of the most controversial topics in perioperative management. Current perioperative fluid therapy is largely based on concepts developed restricted and liberal perioperative fluid administration in the late 1950s and 1960s. However, there are increasing reports of perioperative excessive intravascular volume leading to increased postoperative morbidity and mortality. The concept of individualized goal-directed therapy in surgical patients seems to be an important component for optimization of perioperative fluid management in high-risk surgical patients.
Fluid Therapy ; adverse effects ; methods ; Humans ; Perioperative Care

Recently immunotherapy for gastrointestinal tumor has rapidly developed, and has improved the effect of cancer comprehensive treatment as an adjunctive therapy in combination with surgery, chemotherapy, and radiation therapy. Adoptive transfer of immune cells is an important treatment method for advanced gastric cancer. In this paper, we reviewed the application of adoptive transfer therapy for advanced gastric cancer in the perioperative period and propose a new model for immunotherapy of advanced gastric cancer based on our experience and the results of clinical experiment.
Humans ; Immunotherapy, Adoptive ; methods ; Perioperative Care ; Stomach Neoplasms ; therapy

The excess fatty tissues on the head, neck, thorax, and abdomen of morbid obese patients can impede the patency of the upper airway and impair lung functions. Meanwhile, these patients often have comorbidities such as obstructive sleep apnea, hypoventilation syndrome, chronic obstructive pulmonary disease, and asthma, which may result in difficult airway, intraoperative hypoventilation, and postoperative respiratory depression. Therefore, perioperative airway management for morbid obese patients may pose a big challenge to anesthesiologists. Anesthesiologists should know well about the pathophysiological features of respiratory system and grasp rational management principles, so as to improve the safety and effectiveness of perioperative airway management and optimize the clinical prognosis.
Airway Management ; Anesthesia ; methods ; Humans ; Obesity ; surgery ; Perioperative Care

Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice. As for the postoperative diet strategy, current literature remains non-unified to identify the duration and the content of the nutrition managements. Domestic clinical reports about the postoperative nutrition managements after metabolic surgery are rare and lack of unified and good reference standard. Meanwhile, divergence still existed in current literature regarding to the content of the postoperative nutrition managements. Therefore, it is necessary to develop the standardized protocol for nutrition managements which is offering basis and reference for the clinical application of perioperative nutrition managements after metabolic surgery.
Bariatric Surgery ; Digestive System Surgical Procedures ; Humans ; Nutrition Therapy ; methods ; standards ; Perioperative Care ; methods ; standards

OBJECTIVETo study the effects of different perioperative treatments on the number and proportion of gut flora in SD rats.

METHODSForty-eight SD rats were randomized into 8 groups including the control group, antibiotics group, bowel preparation group, fasting group, antibiotic-bowel preparation group, antibiotics-bowel preparation-fasting group, bowel preparation-surgery-antibiotics-early postoperative feeding group (early feeding group), and bowel preparation-surgery-antibiotics-postoperative fasting group. The rats were sacrificed and stool specimens were collected from the cecum. Stools were diluted and transferred to selective medium. Bacteria counts were calculated after 48 hours of culture under constant temperature. The changes in gut flora between the different groups were compared in terms of E.coli, Bacteroides, Bifidobacterium, and Enterococcus.

RESULTSCompared with the control group, the total bacteria, Bacteroid, Enterococcus, Bifidobacterium were all significantly decreased(P<0.05), while the E.coli count and the bacillus/coccus ratio were significantly elevated(P<0.05). In the bowel preparation group, the total bacteria count, Bacteroid, Enterococcus, Bifidobacterium were all significantly decreased(P<0.05), while the E.coli count remained stable(P>0.05) and the bacillus/coccus ratio was significantly elevated(P<0.05). In the fasting group, the total bacteria count, Bacteroid, Enterococcus, Bifidobacterium were all significantly decreased(P<0.05), while the E.coli count remained stable(P>0.05) and the bacillus/coccus ratio was significantly elevated(P<0.05). Early postoperative feeding increased E.coli, Enterococcus, and total bacteria count(P<0.05), and lowered bacillus/coccus ratio(P<0.05) as compared to the fasting group.

CONCLUSIONSAntibiotics, bowel preparation, and fasting have influence on the gut flora of SD rats in count and bacillus/coccus ratio, leading to dysbiosis. Early postoperative feeding may improve dysbiosis.

Animals ; Feces ; microbiology ; Male ; Microbiota ; Perioperative Care ; methods ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the influence of fast-track surgery in perioperative period on the clinical outcomes of patients with esophageal cancer.

METHODSClinical data of 117 patients with esophageal cancer between January 2011 and June 2011 were retrospectively analyzed. Sixty-three cases (study group) were treated with fast-track surgery and 54 cases(control group) were treated according to routine protocol in the perioperative period.

RESULTSThe operative time, time to drainage tube removal, and length of hospital stay were significantly shorter in the study group than those in the control group(all P<0.05). Compared with the control group, the medical cost was lower(P<0.05). The overall postoperative complication rate was 7.9% in the study group and 24.1% in the control group(P<0.05).

CONCLUSIONFast-track surgery in the perioperative period for patients with esophageal cancer can promote bowel function recovery and decrease morbidity.

Esophageal Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; methods ; Retrospective Studies ; Treatment Outcome

Humans ; Monitoring, Intraoperative ; methods ; Perioperative Care ; Sleep Apnea, Obstructive ; nursing ; therapy