Exploration of the lymph node dissection range and strategies for adenocarcinoma of esophagogastric junction from the perspective of membrane anatomy
10.3760/cma.j.cn441530-20250623-00239
- VernacularTitle:食管胃结合部癌在膜解剖视角下的淋巴结清扫范围与策略探讨
- Author:
Yuwei CAO
1
;
Xiaolong CHEN
1
;
Weihan ZHANG
1
;
Kun YANG
1
Author Information
1. 四川大学华西医院普通外科胃癌中心&胃癌研究室，成都 610041
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of esophagogastric junction;
Membrane anatomy;
Lymph node dissection;
Surgical skills
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(9):993-998
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise globally, with surgical resection representing the primary curative approach. Due to the complex anatomy and heterogeneous metastatic pathways of AEG, lymphadenectomy has become a critical focus in modern surgical oncology. However, traditional TNM staging and Siewert classification exhibit limitations in precisely guiding the optimal extent of lymphadenectomy. Consequently, this review integrated emerging evidence from membrane anatomy theory - a field experiencing breakthrough advances - to systematically explore lymphadenectomy strategies for AEG. Specifically, we analyzed the application of membrane anatomy principles to delineate lymphadenectomy strategies, dissection scope, and key surgical techniques tailored to each Siewert subtype (I, II, III) and varying degrees of esophageal involvement. Based on membrane anatomy, the review proposed specific, anatomically guided lymph node dissection strategies. Furthermore, we evaluated the feasibility, standardization, and clinical significance of membrane anatomy-guided dissection strategies considering recent advances, while also addressing current challenges and future directions for development and validation. Membrane anatomy is anticipated to serve as a novel and essential anatomical foundation for optimizing surgical approaches. Its application thus may hold significant promise for optimizing surgical pathways, enhancing the quality and precision of lymph node dissection, and ultimately improving oncological outcomes.
