从胸外科医师的视角探讨食管胃结合部腺癌外科治疗策略

Surgical treatment strategies for adenocarcinoma of esopha⁃gogastric junction:from the perspective of a thoracic surgeon

近年来,食管胃结合部腺癌(AEG)发病率呈上升趋势。尽管包括外科手术在内的综合治疗策略不断改进,AEG的5年生存率仍然较低。由于AEG解剖学和病理学的特殊性,目前关于其分期、手术径路、淋巴结清扫范围、胃切除范围、消化道重建方式等方面存在争议,缺乏高级别临床研究依据。笔者结合近年来AEG外科治疗相关进展,以胸外科医师的视角探讨AEG外科治疗策略,旨在为广大外科同道提供参考。

The incidence of adenocarcinoma of esophagogastic junction(AEG)has been rising in recent years.Despite that multimodality therapy including surgery advances tremendously,the 5⁃year survival rate of AEG patients remains poor.Due to the particularity of anatomy and pathology of AEG,controversies persist with regard to staging,surgical approaches,scope of lymph node dissection,extent of gastrectomy as well as the reconstruction of digestive tract.High level of evidence based on clinical trials is still lacking.Here,in light of recent progress in surgical treatment of AEG,the authors investigate the related strategies of surgical treatment of AEG from the perspective of thoracic surgeon,in order to provide references to surgeons.