食管胃结合部腺癌外科治疗中国专家共识(2024年版)

Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction(Edition 2024)

《食管胃结合部腺癌外科治疗中国专家共识(2018版)》自颁布以来,很大程度上促进了我国食管胃结合部腺癌(AEG)的规范化、同质化诊疗,提升了我国AEG的外科治疗水平。经过5年的临床实践,该共识普适性和可行性已得到广泛证实。鉴于AEG发病率持续上升的趋势及其解剖部位、临床病理特征和分子生物学特征的特殊性,AEG成为近5年来外科临床研究的热点之一,并不断有新的临床研究证据发表。但是,对于AEG的定义、分型、分期、手术路径、切除范围、淋巴结清扫规范和消化道重建等外科问题,仍旧存在争议。鉴于此,有必要对2018版的共识进行更新。《食管胃结合部腺癌外科治疗中国专家共识(2024版)》在前一版的基础上,整合并分析5年来新的最佳临床证据,参考最新国际指南与共识,结合我国外科专家组意见,针对AEG外科治疗关键环节,包括AEG的定义和分型、手术径路、手术方式、淋巴结清扫范围、消化道重建方式及外科围手术期治疗等存在争议的问题,提出相关推荐建议,以期更好地规范AEG的外科治疗方式。在本共识中未解决的相关问题,尚需积极开展高质量的临床研究,以逐步探索和解决。

The publication of Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction(2018 edition)has widely accelerated the standardization and homogenization on the surgical treatment of adenocarcinoma of esophagogastric junction(AEG).In China,the surgical outcomes of AEG,the universality and practicability of this consensus has also been affirmed after the clinical practice during the past 5 years.Due to the persistent increasing incidence of AEG,the specificity on anatomic site,clinicopathological characteristics,molecular biological characteristics,AEG had been always the hotspot of many clinical trials and more clinical evidences had been published.However,its definition,classification,staging,surgical approach,resection pattern,extent of lymphadenectomy,and the digestive tract reconstruction etc.remain controversial.In light of the above,it is necessary to update the 2018 edition of consensus.The Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction(2024 edition)is generated based on the currently available and best clinical evidence,the latest global guidelines or consensuses,and the opinions from the Chinese expert panel.The present consensus focuses on the key points of surgical treatment and issues in dispute,and provides scientific recommendations.The goal of this expert consensus was to improve the homogeneity in understanding and practice between Chinese thoracic and gastrointestinal surgeons,and to further standardize surgical treatment of AEG.Those pending issues in this consensus need high-quality clinical research to further investigate.