Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.

This book clearly describes the surgical procedures employed in patients with gastric cancer. The techniques used in the various types of gastrectomy are presented step by step, and the roles of endoscopic treatment and chemotherapy are also discussed. A distinctive practical feature is the provision of accompanying online videos of standard surgical procedures, which will serve as excellent learning aids for novice practitioners and provide ideal teaching material for experienced surgeons. Surgery remains the mainstay in the treatment of gastric cancer. With advances in tumor biology and technical developments, gastric cancer surgery has become more diverse and its outcomes have steadily improved. However, further improvement of certain aspects of surgical procedures and techniques is still required. Surgery for Gastric Cancer will acquaint readers with the state of the art in the field and prove a valuable tool in the quest for optimal practice.

Endoscopy in Early Gastrointestinal Cancers, Volume 1: Diagnosis provides detailed information of the technique of novel endoscopic diagnostic tools including magnifying endoscopy, narrow band imaging system (NBI), autofluorescence endoscopy (AFI), endocytoscopy, FICE and confocal endomicroscopy. Carcinoma of the gastrointestinal tract remained a major health issue worldwide, which is, however notoriously difficult to treat. One of the major reasons for such a poor result is that these cancers are diagnosed at advanced stage. There is a recent increase in the number of gastrointestinal cancers diagnosed at early stage. This is attributed to an increasing recognition of these early stage cancers through a recent development in the technology of endoscopy. This book on the endoscopic diagnosis of early GI neoplasia, containing lots of illustrations, artwork and numerous short video clips, serves as a bridge between the recent development in endoscopy and the knowledge of gastroenterologist, endoscopist and surgeons.

Gastrointestinal endoscopy is the principal tool for the investigation and treatment of most diseases of the gastrointestinal tract. The Atlas of Clinical Gastrointestinal Endoscopy offers a comprehensive overview of the role of gastrointestinal endoscopy in diagnosis. The atlas contains an abundance of high-quality images of a wide range of diseases of the upper and lower gastrointestinal tract, accompanied by precise clinical descriptions. Normal findings and variants are also documented. Furthermore, many images obtained by means of advanced image-enhanced endoscopy, capsule endoscopy, device-assisted enteroscopy, and endoscopic ultrasound are included. This book will be an ideal reference for both specialists and trainees in gastroenterology. It will provide the reader with an invaluable store of knowledge and with the clear guidance required in order to perform gastrointestinal endoscopy to best effect.

One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.