摘要
近年来食管胃结合部腺癌(AEG)成为业界关注的学术热点,其中SiewertⅡ/Ⅲ型鉴于切缘、淋巴结清扫及消化道重建等要求,适宜手术路径及适应证等方面尚在共识中。腹部外科治疗AEG的经腹食管裂孔路径(TH)特点是创伤较小,腹腔淋巴结清扫方便,但纵隔淋巴结清扫和消化道重建受限。综合当前的研究证据及国内临床应用现状考虑:选择食管受累距离≤2 cm的SiewertⅡ/Ⅲ型AEG采用TH路径治疗为宜,在此基础上合理设计、开展相关临床研究,获得更多循证医学证据,进一步推动AEG的精准医疗。
In recent years,the adenocarcinoma of esophagogastric junction(AEG)has become an academic hot spot.Due to the requirements of resection margin,lymph node dissection,and digestive tract reconstruction,appropriate operation pathways of SiewertⅡ/Ⅲtype of AEG are still on the consensus.The abdominal-transhiatal approach(TH)to treat AEG is characterized by less injury,convenient abdominal lymph nodes dissection,but limited space for mediastinal lymph nodes dissection and digestive tract reconstruction.Taken the current clinical research evidence and domestic clinical application status,it is more appropriate to choose the TH approach for the SiewertⅡ/ⅢAEG patients whose esophageal was involved less than 2cm.On this basis,relevant clinical studies are still needed to be well designed and carried out to obtain more evidence andpromote the precision medicine of AEG.
作者
王胤奎
李子禹
Wang Yinkui;Li Ziyu(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Gastrointestinal Cancer Center,Peking University Cancer Hospital&Institute,Beijing 100142,China)
出处
《国际外科学杂志》
2020年第8期510-513,共4页
International Journal of Surgery
基金
北京市医院管理局重点医学专业发展计划胃癌专业(ZYLX201701)
登峰人才计划:肿瘤学(DFL20181103)。
关键词
食管胃结合部腺癌
腹部
外科手术
经腹食管裂孔路径
Adenocarcinoma of esophgogastric junction
Abdomen
Surgical procedures,operative
Transhiatal approach
