食管-胃结合部腺癌根治术的争议与评价

Controversy and evaluation of the radical resection for adenocarcinoma of the esophagogastric junction

目前,食管-胃结合部腺癌(AEG)作为一类不同于食管癌和胃癌的独立疾病的临床观点已为多数学者所接受。然而,有关AEG根治术的手术径路、食管胃切除范围、淋巴结清扫范围等问题仍存在争议。临床上应综合病人全身情况、AEG类型、食管浸润范围、cTNM分期、术者的经验和技术条件等因素,平衡手术的安全性和彻底性,选择合理的个体化根治手术方案。

The majority of scholars have agreed that the adenocarcinoma of the esophagogastrie junction （AEG） is an independent tumor entity, which is different from squamous cell carcinoma of the esophagus and gastric adenocarcinoma. But there are still many controversies about the surgical approaches, procedures of resection, and extent of lymph nodes dissection. Clinically, surgical procedure should be tailored individually according to the general condition of the patient, type of AEG, extent of esophageal infiltration, cTNM stage and experiences of the surgeons to get a good balance between the surgical safety and degree of radical resection.