Application of laparoscopy in the diagnosis and treatment of gastric cancer.

The advantages and feasibility of laparoscopic surgeries have been widely recognized in recent years. In China, most gastric cancer cases are already in their advanced stages. Thus, the rational application and promotion of laparoscopic surgeries have become one of the priorities in the management of gastric cancer. First, the roles of laproscopy in the diagnosis and efficacy evaluation of gastric cancer have not been fully recognized. While laparoscopic surgeries have been the standard treatment for the early gastric cancer, surgeons must have a solid knowledge of the indications of endoscopic and laparoscopic surgeries for the early gastric cancer and strictly obey them, so as to avoid excessive treatment. For patients with advanced gastric cancer, the laparoscopic surgeries still lack convincing evidences and require further validation in clinical trials. Currently, many studies on the laparoscopic surgeries for gastric cancer have been conducted in China; however, relevant training, access, and monitoring mechanisms still have not been established or applied. While the patients’ rights and interests should always be prioritized, the learning curves of laparoscopic surgeries as well as the indications of these surgeries for advanced gastric cancer are still problematic. Based on my personal training and experiences, I would like to share my understandings about the rational application of laporoscopy in the diagnosis and treatment of gastric cancer.