In recent years,the incidence of gastric cancer has shown a decreasing trend.However,the incidence of adenocarcinoma of the esophagogastric junction (AEG) is gradually increasing.Different from esophageal cancer and gastric cancer,AEG has distinct pathological types,with low early diagnostic rate and poor prognosis.At present,the main therapeutic measure is surgery for advanced Siewert type Ⅱ and Ⅲ AEG.The key to a successful operation is complete resection of tumor and thorough lymphadenectomy,especially the upper abdominal and inferior mediastinal lymph nodes (No.110 the lower thoracic paraesophageal lymph nodes and No.111 the supradiaphragmatic lymph nodes).For the advanced Siewert type Ⅱ and Ⅲ AEG invading lower thoracic esophagus,it is required to perform gastrectomy with D2 lymphadenectomy,which includes upper abdominal and inferior mediastinal lymphadenectomy.There has been reached a consensus on complete resection of tumor and thorough lymphadenectomy.However,there is still controversy in the inferior mediastinal lymphadenectomy,particularly lower thoracic paraesophageal lymph nodes and supradiaphragmatic lymph nodes.Since specific lymphatic drainage of the esophagogastric junction,it is necessary to dissect inferior mediastinal lymph nodes.The metastatic rate of the inferior mediastinal lymph nodes determines the extent of inferior mediastinal lymphadenectomy.D2 lymphadenectomy (including inferior mediastinal lymphadenectomy) could achieve more thorough clearance for perigastric metastatic lymph nodes.Meanwhile,it could increase the survival rate of postoperative patients and improve their prognosis.

In recent years, the overall incidence of gastric cancer has been decreasing worldwide, while the incidence of the esophagogastric junction tumor is increasing year by year. With the progress of the diagnostic technology of upper gastrointestinal tumors and the gradual popularization of early cancer screening, the detection rate of early esophagogastric junction tumor keeps increasing. Therefore, in recent years, the clinical application of gastric function preserving surgery is gradually increasing. As an important part of the surgical treatment strategy of esophagogastric junction tumors, proximal gastrectomy has attracted more and more attention with the confirmation of oncological safety. Compared with total gastrectomy, patients after proximal gastrectomy have better nutritional status and quality of life. However, the high incidence of reflux esophagitis after traditional proximal gastrectomy has seriously affected the quality of life of patients, and also hindered the application of proximal gastrectomy in esophagogastric junction tumors. How to reduce the occurrence of reflux esophagitis after proximal gastrectomy by optimizing the method of digestive tract reconstruction has been a big challenge in clinical practice. This article reviews the current methods of anti-reflux surgery for proximal gastrectomy for esophagogastric junction tumors, aiming to provide a reference for choosing a reasonable anti-reflux surgery.

In recent years, the overall incidence of gastric cancer has been decreasing worldwide, while the incidence of the esophagogastric junction tumor is increasing year by year. With the progress of the diagnostic technology of upper gastrointestinal tumors and the gradual popularization of early cancer screening, the detection rate of early esophagogastric junction tumor keeps increasing. Therefore, in recent years, the clinical application of gastric function preserving surgery is gradually increasing. As an important part of the surgical treatment strategy of esophagogastric junction tumors, proximal gastrectomy has attracted more and more attention with the confirmation of oncological safety. Compared with total gastrectomy, patients after proximal gastrectomy have better nutritional status and quality of life. However, the high incidence of reflux esophagitis after traditional proximal gastrectomy has seriously affected the quality of life of patients, and also hindered the application of proximal gastrectomy in esophagogastric junction tumors. How to reduce the occurrence of reflux esophagitis after proximal gastrectomy by optimizing the method of digestive tract reconstruction has been a big challenge in clinical practice. This article reviews the current methods of anti-reflux surgery for proximal gastrectomy for esophagogastric junction tumors, aiming to provide a reference for choosing a reasonable anti-reflux surgery.