Barcelona consensus on supermicrosurgery.

The popularity of supermicrosurgery has increased dramatically over the past few years, but the lack of agreement regarding the name of the technique and its applications has caused misunderstandings among microsurgeons when trying to communicate and compare surgical procedures. We report the consensus reached on the name used to refer to supermicrosurgery techniques following the First European Conference on Supramicrosurgery held in Barcelona (Spain) on March 4-5, 2010. Present applications, advantages, and disadvantages of supermicrosurgery are discussed. It was agreed that supermicrosurgery was the most accurate name to reflect the essence of this extremely delicate technique. According to Koshima, supermicrosurgery is a technique of microneurovascular anastomosis for vessels of 0.3 to 0.8 mm and single nerve fascicles. The range of applications for this technique has increased rapidly and now includes lymphedema treatment, nerve reconstruction, replantation and reconstruction of amputated fingertips, microsurgical flap salvage, and new possibilities for free tissue transfer. Supermicrosurgery is a remarkably useful reconstructive tool that involves a great deal of skill and has a steep learning curve for the microsurgeon to master. Although it is currently performed by only a minority of microsurgeons, we consider it will be incorporated into conventional microsurgery in the near future.

[Detection of early esophageal and gastric cancers by mass screening].

The purpose of mass screening is to decrease the mortality rate of diseases which are fatal if advanced by detecting them at an early and curable stage. From this point of view, we describe here the present state of mass screening, its problems, and the future of mass screening for esophageal and gastric cancer in Japan. The conventional X-ray examination commonly used to detect esophageal cancer does not seem to be effective in detecting the malignancy at an early stage. Therefore, endoscopic examination with Lugol staining for high-risk groups is recommended for the purpose. In contrast, mass screening for gastric cancer by X-ray examination, which has been applied until now, has reduced the mortality rate of gastric cancer. At the same time, however, as various problems are pointed out, some additional investigations have been undertaken to further reduce the mortality rate of gastric cancer. As social circumstances change, and therapy as well as diagnosis for the disease improves, it is necessary to evaluate the accuracy, problems, and limits of the present system to conduct effective and functional mass screening program. The present system must be adapted it to reflect improvements and changes.