胃癌新辅助和转化治疗后手术的难点与要点OA北大核心CSTPCD

With the continuous improvement in the efficacy of drug treatment for gastric cancer,the application of neoadjuvant therapy and conversion therapy become more acceptable.However,the timing of surgery,the selection of surgical procedures and surgical scope,the standard treatment of intra-and postoperative complications,the timing of postoperative treatment,and the optimal drug regimen still lack high-level research evidence.Up-to-date research results showed that neoadjuvant therapy did not increase the complications after total or distal gastrectomy.Meanwhile,total laparoscopic surgery after neoadjuvant therapy had certain advantages over laparoscopic-assisted surgery.Proximal gastrectomy could be considered for patients meeting the indications after neoadjuvant treatment as well.At the same time,it was recommended that the surgery should be performed within 6 weeks after chemotherapy.Conversion therapy is still in the exploratory stage.Based on the multidisciplinary discussions,patients'conditions should be considered and both doctors and patients should participate in decisions when selecting surgery timing.To benefit the patients most,corresponding clinical studies should be carried out pertinently meanwhile multidisciplinary cooperation and the participation of doctors and patients in decisions should gain more attention.