Several issues on surgical treatment for adenocarcinoma of esophagogastric junction.
10.3760/cma.j.cn112139-20220417-00172
- Author:
Lin CHEN
1
;
Xin Xin XU
1
;
Yi Xun LU
1
;
Ke Cheng ZHANG
1
Author Information
1. Department of General Surgery, the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
- Publication Type:Journal Article
- MeSH:
Adenocarcinoma/surgery*;
Esophageal Neoplasms/surgery*;
Esophagogastric Junction/surgery*;
Gastrectomy/methods*;
Humans;
Stomach Neoplasms/surgery*
- From:
Chinese Journal of Surgery
2022;60(9):807-812
- CountryChina
- Language:Chinese
-
Abstract:
There are several controversies and issues in the surgical treatment of esophagogastric junction (AEG) currently. The Siewert classification and TNM staging system are commonly used to assist clinical decision and prognosis prediction. Generally, transthoracic procedure is more suitable for Siewert Ⅰ type and longer esophageal invasion patients, while transhiatal is more suitable for Siewert Ⅲ type patients. The optimal extent of lymph node dissection for AEG should be based on tumor location and esophageal invasion range. The extent of surgical resection and the method of digestive tract reconstruction should be based on the principle of radical resection and surgical safety, and the postoperative life quality of patients should be fully considered. Roux-en-Y anastomosis is the most common and efficient anastomosis after total gastrectomy, while double tract anastomosis is recommended by many experts after proximal gastrectomy. With the continuous advancement of minimally invasive techniques, experienced centers and teams can perform digestive tract reconstruction under total laparoscopy. In the future, more high-quality studies are expected to provide evidence-based medical evidence for AEG's surgical treatment decisions.
