演講人：日期：胃癌手術英語目錄OverviewofgastriccancersurgeryPreparationbeforesurgeryDetailedexplanationofthesurgicalprocessPostoperativetreatmentmeasuresDrugtreatmentplan01OverviewofgastriccancersurgeryDefinitionGastriccancersurgeryreferstothesurgicalremovalofmalignanttumorsintheStomachClassificationGascancercanbeclassifiedintoearlygascancerandadvancedgascancerbasedonthedepthofinvasionandlymphnodemetastasisSurgicalproceduresvaryaccordinglyDefinitionandclassificationHelicobacterpyloriinfectionAmajorcauseofgascancer,chronicinfectioncanleadtogasinflammationandinfection,whichmaypotentiallydevelopintocancerUnhealthydieAdiehighinsalt,nitrate,andpickledfoodsmayincreasetheriskofgascancerSmokingandalcoholconsumptionBothareknownriskfactorsforgascancerFamilyhistoryIndividualswithafamilyhistoryofgastriccancermaybeatincreasedriskCausesandriskfactorsofonsetEndoscopeThemostcommondiagnosticmethod,allowingdirectvisualizationoftheStomachliningandbiopsyofsuspiciouslessonsIncludingcomputedtomography(CT)andmagneticresonanceimaging(MRI),whichcanassesstheextentoftumorinvasionandmetastasisBloodtestsmaybeusedtodetecttumormarkersandassessoverallhealthstatusThegoldstandardfordiagnosis,involvingthemicrosurgicalexaminationofissuesamplestoconfirmthepresenceofcancercellsImagingstudiesLaboratorytestsPathologicalexaminationDiagnosticmethodsandstandardsRemovalofthetuberSurgicalrecoveryistheprimarytreatmentforgastriccancer,aimingtocompletelyremovethetuberandsurroundinglymphnodesBeliefofsymptomsSurgerycanallocatesymptomssuchasexcessivepaint,blending,andobstructioncausedbythetutorImprovementofsurvivalSurgicaltreatmentcansignificantlyimprovethesurvivalrateofpatientswithgastriccancer,specificallywhencombinedwithadvancedtherapiessuchaschemotherapyandradiationPurposeandsignificanceofsurgicaltreatmentQualityoflifeByremovingthetuberandrelievingsymptoms,surgerycangreatlyimprovethequalityoflifeforpatientswithgastriccancerPurposeandsignificanceofsurgicaltreatment02Preparationbeforesurgery輸入標題02010403PatientevaluationandscreeningComprehensiveassessmentofthepatient'sphysicalcondition,includingevaluationofcomorbiditiesandoverallhealthstatusScreeningforpotentialsurgicalcontraindicationsandriskfactorsAssessmentofthepatient'snutritionalstatusandcorrectionofmalnutritionifnecessaryDeterminationoftheclinicalstageofgascancerthroughdiagnosticimagingandendoscopicexaminationIntroductiontopreoperativeexaminationitems01Routinebloodtests,includingcompletebloodcount,liverandkidneyfunctiontests,andelectrolytelevels02Cardiovascularevaluation,suchaselectrocardiogramandechocardiogram,toassesscardiacfunction03Pulmonaryfunctionteststoevaluaterespiratoryfunctionandidentifypotentialrespiratorycomplexes04Imagingstudies,includingcomputedtomography(CT)andendoscopy,toassesstheextentandlocationofthetutorGeneralanesthesiaistypicallyusedforgastriccancersurgery,ensuringthepatientisunconsciousandunabletofeelpaidduringtheprocedureSelectionofAnesthesiamethodisbasedonthepatient'sphysicalconditions,comorbidities,andsurgicalrequirementsAnesthesiaisadministeredbyaqualifiedanesthesiologistwhomonitorsthepatient'svitalsignsthroughoutthesurgeryAnesthesiamethodsandselectioncriteriaTheoperatingroomisasterileenvironmentwithstrictinfectioncontrolmeasuresinplaceTheoperatingtableandlightsareadjustedtoprovideoptimalaccessandvisibilityfortheearthquakeAllsurgicalinstrumentsandequipmentarestandardizedbeforeusetopreventsurgicalsiteinfectionsEmergencyequipmentandmedicineareavailableintheoperatingroomtomanagepotentialapplicationsduringsurgeryOperatingroomenvironmentandequipmentpreparation03DetailedexplanationofthesurgicalprocessInfectionThesurgicalsiteiscleanandaffectedwithadversesolutionstominimizetheriskofinfectionDrapingSteriledrapesareplacedaroundthesurgicalsitetocreateaSterilefieldandprotectthepatient'sskinandclothingfromcontainmentOperatingProceduresforDiscriminationandTowelingThelocationofthedecisiondependsonthelocationandsizeofthetutor,aswellasthelargerone'spreferenceCommondecisionlocationsincludetheupperabdomensorchestsDecisionlocationSurgicalinstrumentsareusedtogenerouslyretractandholdorgansandissuestoexposethesurgicalsiteandprovideaclearviewforthesurgeryExposureDecisionselectionandexposuretechniquesAbsoluteexplorationThelarge-scalecarefullyexaminedtheapproximateactivitytoassessthelocation,size,andextentofthestudentLessonassessmentThelargedecisionsoftheextentofthesectionbyvisualinspectionandpaintingtheaffectedareaThisinformationiscriticalforplanningthesurgicalapproachandrecoverymarginsExplorethedominantactivityanddeterminetheextentoftheregionLimphnodemappingThelargeidentitiesandmapsofthelocationofLimphnodesthatarepotentiallyaffectedbythetuberLymphnodedissectionLymphnodesarecarefullydissectedandremovedfromthesurgicalsiteThenumberandlocationofsimplenodesremoveddependonthestageandaccumulationofthetutorLymphnodesegmentationstrategy04PostoperativetreatmentmeasuresGastriccancersurgeriesinvolvetheuseofvariousSuturetechniquestocloseimpactsandreconnectissuesThesetechniquesincludesimpleinterruptedcases,continuouscases,andsubcircularcases,dependingonthelocationandsizeofthedecisionSuturetechniquesControllingblendingduringandaftersurgeryiscriticalHematosismethodssuchaslighting,computerization,andtheuseofhomeostaticagentsareemployedtoensureproperclosingandpreventexcessivebloodlossHemostasismethodsSuturetechniquesandhypothesismethodsKeypointsforplacementandcareofdrainagetubesDrainagetubesareplacedduringsurgerytocollectfluidsandairthatmayaccumulateintheabdominalcavityProposeplacementguaranteeseffectivedrainageandreducetheriskofcomplicationsPlacementPostoperativecareofdrainagetubesinvolvesmonitoringtheamountandtypeoffluiddrained,maintainingthepatienceofthetubes,andregularcleaninganddressingchangestopreventinfectionCareStrictalkalinetechnologiesduringsurgeryandproperwoncareaftersurgeryareessentialtopreventsurgicalsiteinfectionsAntibioticsmayalsobeadministeredtoreducetheriskofinfectionAnastomoticleakisaseriouscomplicationaftergascancersurgeryTopreventthis,surgeonsemploymedicallysignificantsurgicaltechniquesandmayuseadditionalfeaturesorstentstoreinforcetheanatomyBleedingcanoccurduetovariousreasonssuchaspotentiallinefailuresorcoaggregationdisordersTopreventthis,surgeonsensureproperhygieneduringsurgeryandmonitorpatientscloseforanysignsofbleedingpostoperativelyInfectionpreventionPreventionofanatomicalleakPreventionofbleedingPreventionstrategiesforapplicationsDietaryguidancePatientsareadvisedtofollowaspecificdieplanthatgradienttransitionsthemfromaliquiddietosolidfoodsThishelpstoensurepropernutritionandhealingExerciseandactivityMilkexerciseandactivityareenrichedtoimprovecirculation,preventconstipation,andaidinrecoveryHowever,patientsshouldavoidstrenuousactivitiesuntilfullyrecoveredRehabilitationguidancerecommendationsEmotionalsupportCopingwiththeemotionalaspectsofgascancersurgeryisimportantPatientsmaybenefitfromcounselingandsupportgroupstohelpthemdealwithanxiety,depression,andotheremotionalissuesrelatedtotheirdiagnosisandtreatmentFollowupcareRegularfollowupvisitswiththesurgeryandoncologyareessentialtomonitorrecovery,detectanyrecurrenceorcomplicationsearly,andadjusttreatmentplansaccordinglyRehabilitationguidancerecommendations05DrugtreatmentplanPlatinumbaseddrinksInferewithDNAreplicationandtranscription,leadingtocelldeathCommonlyuseddrugsincludecisplatin,carboplatin,etcFluoropyrimidinesInhibitDNAsynthesisbyinferencewiththemetabolismofnuclearacidsRepresentativedrinksinclude5-fluorouracilanditsderivativesTaxanesStabilizemicrotublesandinhibitcelldivision,thereisalearningopportunityoreffectsCommonlyuseddrugsincludepaclitaxel,docetaxel,etcTypesandmechanismsofactionofchemotherapydrugsHER2targetedbugsTrastuzumabisarepresentativebugthatspecificallybindstoHER2receiversandinhibitorstubergrowthVEGFtargeteddrinksBevacizumab,ramucirumab,etc.,caninhibittumorangiogenesisandmetastasisbyblockingVEGFsignalingpathwaysImmunecheckpointinhi