Recognition of specialization of minimally invasive treatment for gastric cancer in the era of precision medicine / 中华胃肠外科杂志

ABSTRACT

With the introduction and promotion of "precision medicine" conception, the history of disease occurrence, progression and prognosis has been deeply investigated with more accuracy, and the surgical treatment concept has become more precise and minimally invasive. With the rapid development of minimally invasive technique, laparoscopic gastrectomy has become an important part for treatment of gastric cancer. A number of randomized controlled clinical trials, such as KLASS-01 and CLASS-01, have demonstrated that laparoscopic gastrectomy is safe and feasible for treatment of early and locally advanced gastric cancer, respectively. Endoscopic treatment would also be considered with strict indications. The surgical safety is identical between standard laparoscopy surgery and open surgery for local advanced gastric cancer. Radical cure, organ function preservation and reduced surgical trauma are the basic rules for minimally invasive treatment for gastric cancer. Specialized treatment mode, which consists of precise evaluation of tumor location, gastrectomy and lymph node resection, reduced surgical trauma and control of postsurgical complications, is the premise for implementation of minimally invasive surgery. Accurate preoperative staging, strict indication of operation, accurate quality control and postoperative management are important warrants for the effect of minimally invasive treatment in patients with gastric cancer. With standard diagnosis and treatment procedures, the specialized treatment mode for gastric cancer combined with standard surgical resection is an important force to promote the development of minimally invasive surgery. And what should we do to train and promote gastric cancer treatment in primary medical care centers is an urgent problem. With the development of equipment, minimally invasive treatment will be more professional, more precise, safer and less invasive. In the era of precision medicine, with deeper exploring the pathogenesis of gastric cancer, promoting the development of specialized treatment mode and strengthened surgical team training could meet the demand for minimally invasive treatment of gastric cancer. Therefore, specialized minimally invasive treatment is the trend of minimally invasive treatment for gastric cancer in the new era.