Surgical treatment strategies for Siewert type II adenocarcinoma of the esophagogastric junction

VernacularTitle:SiewertⅡ型食管胃结合部腺癌的手术治疗策略
Author: Qian YAN ¹ ; ZeJian LYU ; Jiabin ZHENG ; Yong LI
Author Information

1. 广东省医学科学院（广东省人民医院）普通外科，广州　510080（现就读于南方医科大学第二临床学院，广州　510515）
Keywords: Adenocarcinoma of the esophagogastric junction, Siewert II; Lymphadenectomy; Digestive tract reconstruction
From: Chinese Journal of Gastrointestinal Surgery 2020;23(10):1008-1012
CountryChina
Language:Chinese
Abstract: The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise. While many treatment modalities are available, surgery is still the basis of comprehensive treatment of AEG. Siewert type II AEG, is more controversial than the other two types in terms of lymph node metastasis, surgical approach, extent of resection, and digestive tract reconstruction. When the distance of the superior tumor margin is more than 3 cm proximal to the EGJ line is more than 3 cm, thorough mediastinal lymph node dissection should be performed through thoracic approach. Total gastrectomy is the treatment of choice for Siewert type II tumors. When the tumor stage is in an early stage, the length of the tumor is ≤4 cm, and esophageal involvement is less than 3 cm, transthoracic esophagectomy plus proximal gastrectomy is feasible. The digestive tract reconstruction can be based on the experience of the operator and patient's choice of conditions.