从腹部外科医师的视角审视食管胃结合部腺癌诊断与治疗策略之演变发展趋势

Evolution and development of the diagnosis and treatment of adenocarcinoma of esophagogastric junction:from the perspective of a general surgeon

食管胃结合部腺癌(AEG)的发病率全世界呈逐年上升趋势,而外科治疗在AEG的综合治疗中仍占据最重要地位。由于AEG肿瘤部位和生物学行为的特殊性,腹部外科医师与胸外科医师在淋巴结清扫策略、手术切除范围和手术径路选择上尚未完全达成共识。微创技术的发展使腹腔镜联合胸腔镜治疗AEG成为可能。随着新辅助治疗地位的提升,未来AEG的诊断与治疗亦需通过多学科团队协作模式共同完成。笔者从腹部外科医师的视角,总结AEG诊断与治疗的现状和争议,审视其研究进展。

The incidence of adenocarcinoma of esopha⁃gogastric junction(AEG)is increasing worldwide annually.Surgical resection still plays the most important role in multi⁃modality therapy for AEG.However,due to the specialities of tumor location and biological features,general surgeons and thoracic surgeons do not reach an agreement on regional lymph⁃adenectomy,extents of resection,surgical approaches,etc.The development of minimally invasive surgery makes it possible to operate by laparoscopy and thoracoscopy.With the promotion of neoadjuvant therapy,a multidisciplinary team will be essential for optimal diagnosis and treatment in the near future.From the developmental perspective of a general surgeon,the authors summarize current status and controversies of the diagnosis and treatment of AEG,and inspect its research advances.