食管癌根治术手术入路

Surgical approach for esophageal cancer

由于食管解剖的特殊性,经左胸、右胸、食管裂孔等入路均可以完成对病变食管的切除和消化道的重建。同时因为食管解剖的复杂性,不同手术入路的治疗效果也有所不同。由于暴露范围、淋巴结清扫和切除范围的局限性,经左胸入路目前已不被作为主要选择。经右胸入路对淋巴结清扫更彻底,是目前公认最能达到肿瘤学根治性切除目的的手术方式。经食管裂孔入路创伤较小但操作空间狭小、难度较高,在临床上尚未大规模开展。微创食管癌根治术的发展也为食管癌的入路选择提供了新思路。本文对已有的食管癌根治术手术入路进行简述。

Due to the anatomical specificity of esophagus,esophagectomy can be carried out using different approaches,such as left transthoracic,right transthoracic and transhiatal approaches.Each surgical approach is associated with a different prognosis due to the complex anatomy.The left transthoracic approach is no longer the primary choice due to its limitations in providing adequate exposure,lymph node dissection,and resection.The right transthoracic approach is capable of achieving a larger number of dissected lymph nodes and is currently considered the preferred procedure for radical resection.Although the transhiatal approach is less invasive,it could be challenging to perform in a limited operating space and has not been widely adopted in clinical practice.Minimally invasive esophagectomy offers a wider range of surgical options for treating esophageal cancer.This paper reviews different approaches to esophagectomy.