1. What is stomach cancer? What is its incidence? Gastric cancer is a malignant tumor occurring in the epithelium of gastric mucosa. It is the most common malignant tumor of gastrointestinal tract in China, ranking the first in gastrointestinal tract tumors, and the mortality rate accounts for 26.1% (male) and 18.7% (female) of all malignant tumors, ranking the first in all kinds of malignant tumors. There are nearly 200,000 new cases of stomach cancer in China every year, and the number of deaths from stomach cancer is about 150,000 every year. The high incidence of stomach cancer in China is at the age of 50-60, but in recent years, there is a trend of increase in the number of young stomach cancer patients. 2. What factors are related to the occurrence of cancer? Gastric cancer is a complex process related to many factors, the main factors are as follows: (1) Dietary factors: food may contain certain carcinogenic substances, and the main chemical carcinogens include nitrosamines (as well as their predecessors nitrates and nitrites) and polycyclic aromatic hydrocarbons (PAHs) compounds. Foods related to the former include: salt-cured foods, high-salt diets, etc. Foods related to the latter are mainly smoked foods such as smoked fish and bacon. Toxins produced by moldy foods and food additives are considered carcinogenic. (2) Genetic factors: Gastric cancer shows family aggregation in a few families. The incidence rate among first-degree relatives of stomach cancer patients is 2-4 times higher than that of the general population. (3) Certain chronic diseases: chronic atrophic gastritis, gastric polyps, gastric ulcer, Helicobacter pylori infection, or patients more than 10 years after major gastric resection. (4) In addition, psychological factors also have a certain influence on the occurrence of tumors, and people with depressed character are more likely to develop tumors. 3.What is early gastric cancer? What are the manifestations of early gastric cancer? Early gastric cancer refers to gastric cancer with lesions limited to mucosa or submucosa. Since the 5-year survival rate of early gastric cancer after operation can reach 90-95%, while the 5-year survival rate of middle and late gastric cancer after operation is less than 20%, therefore, early detection, diagnosis and treatment of gastric cancer is the key to improve the treatment effect. Therefore, early detection and early treatment is the key to improve the treatment effect. As stomach is a large cavity organ, early stomach cancer often has no specific symptoms, or even no symptoms at all, but the following signals should be highly valued. (1) Upper abdominal pain: It is the most common symptom of stomach cancer. It starts with intermittent vague pain, which is often diagnosed as gastritis or ulcer disease, and can be relieved with appropriate treatment. However, it should be noted that abdominal pain of stomach cancer is different from that of gastritis or ulcer disease in that it often has no triggers (such as catching cold or eating cold and hard food), and the pain is not regular, and it can not disappear completely after treatment. (2) Upper abdominal discomfort: mostly a feeling of fullness or burning. It can be temporarily relieved and recurring. This symptom has a vague feeling and is not easy to be taken seriously. (3) Indigestion symptoms such as loss of appetite and belching: manifested by a feeling of fullness after eating and active restriction of diet, often accompanied by repeated belching. (4) Positive black stool or fecal occult blood: the stool can be blackened if there is gastrointestinal bleeding of more than 50 milliliters, and the fecal occult blood can be positive if there is bleeding of more than 5 milliliters. Due to the stimulation of gastric acid, stomach cancer often breaks down and bleeds a little, so 50~65% of patients can show positive fecal occult blood in the early stage. If you have black stools without eating bloody tofu or taking bismuth or other medicines, you should come to the hospital as soon as possible for examination. (5) Lack of energy, emaciation and anemia: this is another group of common but not specific gastric cancer symptoms. Patients often have fatigue and weakness due to loss of appetite and loss of blood in digestive tract at the same time. 4. Who should be more alert to stomach cancer? (1) Patients with history of chronic atrophic gastritis, gastric polyp, gastric ulcer and after subtotal gastrectomy need regular follow-up. (2) Male patients over 40 years old with previous history of ulcer and recent disappearance of regularity of ulcer pain. (3) Elderly patients with vague pain in the upper abdomen or unexplained lethargy and fatigue. (4) Elderly patients, appearing abdominal discomfort, anemia, black stool, etc. 5. What are the main treatments for stomach cancer? (1) Surgical treatment: Surgical resection is the most effective treatment method at present and the only way to cure stomach cancer. Therefore, as long as the patient’s general condition allows, and there is no extensive distant metastasis, surgical resection should be performed. The choice of gastric cancer surgery is mainly based on the results of various auxiliary examinations before surgery, the patient’s age, general condition, and the findings during surgery. Generally speaking, there are the following surgical methods: ① Radical surgery for gastric cancer: the patient’s general condition permits and there is no clear distant metastasis. If the gastric cancer directly invades the neighboring tissues or organs, combined organ resection may be needed. ② Palliative surgery: if distant metastasis occurs, gastric cancer resection with removal of primary tumor and various short-circuit surgeries without removal of gastric cancer will be performed according to the primary tumor and metastasis. Although resection of the tumor can obviously improve the effect of other auxiliary treatments after surgery, if the tumor has widely invaded the surrounding organs or has encircled and invaded the large blood vessels, forcible resection will result in massive bleeding, and the patient may not be able to tolerate the surgery or recover from the surgery, in which case short-circuit surgery is the only option to solve the problem of the patient’s food. (2) Chemotherapy: it is mainly applicable to the adjuvant treatment before, during and after surgery or the treatment of advanced gastric cancer patients who cannot be operated. Chemotherapy is more effective when the number of metastatic cells is relatively small, therefore, it is best to start chemotherapy at an early stage after surgery. When it comes to chemotherapy, people tend to associate it with horrible scenes such as “hair loss” and “vomiting”, but nowadays, due to the advancement of drugs and the improvement of drug application methods and methods, the side effects of chemotherapy have been effectively curbed, and I am no longer afraid of chemotherapy. I am no longer afraid of chemotherapy” has finally become a reality. (3) Radiotherapy: Radiotherapy is mainly used in the treatment of advanced gastric cancer. It can relieve pain and stop bleeding. (4) Immunotherapy: It mainly includes ① non-specific immune enhancers to improve immunity, such as thymic peptide, interferon, etc., ② infusion of anti-tumor antibodies and various cytokines to activate immune cells to kill tumors, such as CD3AK cells, etc. ③ tumor immune vaccine to enhance the body’s immunity. ③Tumor immune vaccine to enhance the specific resistance of the body to tumor stem cells. (iv) Change the biological characteristics of tumor cells in order to make the tumor reverse and subside naturally. Any malignant tumor cannot be cured by a single means of treatment. It is necessary to reasonably formulate a comprehensive treatment plan and require close cooperation between patients and doctors to overcome the disease. 6. How to prevent stomach cancer? (1) Pay attention to diet, eat more fresh vegetables and fruits, garlic and green onion containing mercaptans, soybean and milk products, fresh meat, fish, tea, avoid high salt diet, avoid salted or smoked food. (2) Patients with family history of gastric cancer or suffering from chronic atrophic gastritis, gastric polyps, gastric ulcer, Helicobacter pylori infection, or more than 10 years after major gastrectomy need close follow-up. Keep your mood cheerful. 7. What is colorectal cancer? What is its incidence? Colorectal cancer is a malignant tumor that occurs in the mucosal epithelium of colon and rectum. It is a common malignant tumor of digestive tract in China, and its incidence rate and mortality rate rank the top of malignant tumors. In recent years, the incidence of colorectal cancer in China has been increasing year by year, and its high incidence is at the age of 40~50, but in recent years, there is an increasing trend of young colorectal cancer patients. 8. What factors are related to colorectal cancer? The occurrence of colorectal cancer is a complex process related to many factors, the main factors are as follows: (1) Dietary factors: it is generally believed that high-fat and high-animal protein diet and insufficient fiber in food are the main reasons for the development of colorectal cancer. (2) Hereditary factors: colorectal cancer shows family aggregation in a few families, and it is estimated that about 10% of colorectal cancer is related to heredity. (3) Certain chronic diseases: ulcerative colitis, Crohn’s disease, colorectal polyps and so on. 9. What are the manifestations of early colorectal cancer? Colorectal cancer grows slowly and metastasizes at a later stage, if it can be detected, diagnosed and treated early, the prognosis is better. Early colorectal cancer often has no specific symptoms or even no symptoms at all. If there are the following signals, they should be highly concerned: (1) Change of bowel habit: increased frequency of bowel movement or stool with mucus, alternating between diarrhea and constipation, more than 3 weeks should be paid special attention to. (2) Change of fecal character: persistent or recurrent bloody or pus-blood stools, or the feeling of incomplete stool evacuation; the appearance of thinning, flattening or grooves of stools, which is mostly caused by the compression of rectal cancerous tumors. (3) Persistent lower abdominal discomfort, dull pain or abdominal distension. (4) Black stool or positive fecal occult blood: if you have anemia or have black stool without eating animal blood, taking bismuth and other medicines, you should come to hospital for examination as soon as possible. 10.What are the examination methods for colorectal cancer? (1) Rectal diagnosis is an important examination method for early detection of rectal cancer. (2) Fecal occult blood test: it can provide clues for census screening and early diagnosis. (3) X-ray gas-barium double contrast and fiberoptic colonoscopy: although such examinations will make most patients feel uncomfortable, they are the most important examinations for colon tumors. (4) CT or angiography. (5) Determination of tumor markers: although tumor markers such as CEA and CA19-9 lack specificity in diagnosing colorectal cancer, they are of some significance in determining the effect of surgery and detecting postoperative recurrence. 11. What are the main treatment methods for colorectal cancer? (1) Surgical treatment: Surgical resection is currently the most effective treatment method and the only way to potentially cure colorectal cancer. Therefore, as long as the patient’s general condition permits and there is no extensive distant metastasis, surgical resection should be performed. The choice of colorectal cancer surgery is mainly based on the results of various auxiliary examinations before surgery, the patient’s age, physical condition, and what is seen in the exploration during surgery after comprehensive analysis. For patients with rectal cancer, due to the deepening of the understanding of the disease and the application of double anastomosis, the “anus-preserving rate” has been greatly improved, which makes it possible for most of the patients to get rid of the “fecal bag” and greatly improve the quality of life. (2) Chemotherapy: it is mainly applied to the adjuvant treatment before, during and after surgery or the treatment of advanced colorectal cancer patients who cannot be operated. Chemotherapy is more effective when the number of metastatic cells is relatively small, therefore, it is best to start chemotherapy at an early stage after surgery. (3) Radiotherapy: radiotherapy is mainly used in the treatment of advanced colorectal cancer. (4) Immunotherapy: it mainly includes: ① Non-specific immunity enhancers to improve body immunity, such as thymic peptide and interferon. ② Infusion of anti-tumor antibody and various cytokines to activate immune active cells to kill tumors. ③ Tumor immune vaccine to enhance the body’s specific resistance to tumor stem cells. ④ Change the biological characteristics of tumor cells in order to make the tumor reverse and subside naturally. Any malignant tumors cannot be cured by a single treatment, but must be reasonably formulated as a comprehensive treatment plan, and require close cooperation between patients and doctors to overcome the disease. 12.How to prevent colon cancer? (1) Avoid high-fat diet, eat more food rich in fiber, keep smooth bowel movement, eat more fresh vegetables and fruits, especially yellow-green vegetables rich in vitamins A and C. (2) Preventing and controlling pre-colorectal cancer and eradicating colonic adenomatous polyps. Especially for familial colon polyposis, partial or total colon resection should be done as early as possible. Vigorously prevent and control schistosomiasis, and actively treat chronic inflammation of the colon. Regular colonoscopy should be performed for people over 40 years old or with family history of colorectal cancer. 13.Television laparoscopy in gastrointestinal surgery With the development of science and technology, more and more high technology has been widely used in clinic, among which the appearance of television laparoscopy is regarded as an important milestone in the development of abdominal surgery. Since the successful implementation of the first case of TV laparoscopic cholecystectomy in 1987, after more than a decade of continuous exploration and efforts of surgeons in various countries as well as the emergence of new laparoscopic instruments and equipment, laparoscopic surgery has evolved from a single cholecystectomy to the point that today it is possible to perform dozens of abdominal surgeries via laparoscopy. The so-called television laparoscopic surgery is in different parts of the abdomen to make several small incisions of 5 to 12 mm in diameter, through these small incisions inserted into the camera lens and a variety of special surgical instruments, will be inserted into the abdominal cavity camera captured by the abdominal cavity of various organs of the image transmitted to the television screen, the surgeon through the observation of the image, the use of a variety of surgical instruments outside the body to operate to complete the operation. At present, the gastrointestinal surgeries that can be performed by TV laparoscopy are as follows: (1) appendectomy; (2) repair of perforated gastric ulcers; (3) major gastrectomy; (4) radical surgery for early gastric cancer; (5) resection of some benign and malignant tumors of the colorectum. Compared with traditional open gastrointestinal surgery, laparoscopic gastrointestinal surgery has the following main features: (1) less surgical trauma; (2) quicker recovery of patients; (3) shorter hospitalization time; (4) less postoperative pain of patients; (5) less scarring of the abdominal incision, which is aesthetically pleasing; and (6) the same therapeutic effect as open surgery. It is believed that with the development of surgical techniques and medical science and technology, the application of TV laparoscopic surgery in gastrointestinal surgery will become more and more extensive, providing better treatment means for the majority of patients and relieving their pain.