Understanding of the lower mediastinal lymph node dissection in the adenocarcinoma of the esophagogastric junction through abdomino-transhiatal approach
10.3760/cma.j.issn.1671-0274.2019.10.006
- VernacularTitle: 对食管胃结合部腺癌经腹食管裂孔入路进行下纵隔淋巴结清扫的认识
- Author:
Wenqing HU
1
,
2
;
Peng CUI
3
;
Jinjie ZHANG
3
;
Zuqi ZHAO
4
;
Junwen XU
4
;
Xuemin LIU
5
;
Jie WANG
3
;
Ruilong NIU
3
;
Yong LIU
3
Author Information
1. Department of Gastrointestinal Surgery, Changzhi People′s Hospital, Shanxi Changzhi 046000, China
2. Department of Gastrointestinal Surgery, the Affiliated Heji Hospital of Changzhi Medical College, Shanxi Changzhi 046000, China
3. Department of Gastrointestinal Surgery, the Affiliated Heji Hospital of Changzhi Medical College, Shanxi Changzhi 046000, China
4. Department of Radiology, the Affiliated Heji Hospital of Changzhi Medical College, Shanxi Changzhi 046000, China
5. Department of Human Anatomy, Department of BasicMedicine, Changzhi Medical College, Shanxi Changzhi 046000, China
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of the esophagogastric junction;
Lower mediastinum;
Lymph node dissection
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(10):932-936
- CountryChina
- Language:Chinese
-
Abstract:
In recent years, the incidence of adenocarcinoma of esophagogastric junction (AEG) keeps increasing. Siewert type II and type III AEG invades at 2-4 cm in the lower esophagus, and it has a higher rate of lower mediastinal lymph node metastasis. Lower mediastinal lymph node clearing through the abdomino-transhiatal (TH) approach is preferred, which can be accomplished by entering the lower mediastinum through the hiatus and mobilize the esophagus upward and the surrounding lymph and connective tissue for approximately 6.5 cm. Using the infracardiac bursa (IBC) as an anatomical landmark improves the safety and operability of the thorough dissection of the lower mediastinum. Total resection of the mesenterium at the esophagogastric junction can entirely dissect the lower mediastinal lymph nodes, which conforms to the safety principles in oncology.
