医学
食管胃交界处
食管切除术
淋巴结切除术
腺癌
食管癌
放射科
癌症
普通外科
胃食管交界处
内窥镜检查
外科
内科学
作者
Nicolás Devaud,Paul Carroll
标识
DOI:10.1016/j.thorsurg.2022.07.004
摘要
The optimal management of Siewert Type II or Junction AEG II adenocarcinoma remains a point of debate. Surgical options include an extended total gastrectomy or esophagectomy. Accurately identifying the location of the esophagogastric junction (GEJ) is important as the epicenter of the lesion is defined in reference to the GEJ. Type II tumors, in the most recent iteration of the AJCC, describe these lesions as being within 1 cm cephalad and 2 cm caudal to GEJ. Accurate staging of the location and identification of nodal metastasis is vital to guide the optimal surgical approach. Endoscopy, endosonography, CT, and PET help guide decision-making as to what junctional subtype is present. The extent of resection and lymphadenectomy remains contestable. Both surgical approaches remain viable, as each has its own advantages and issues. The key to the management of these cancers is that the surgeon has the capability to operate on both sides of the diaphragm to manage these oftentimes challenging malignancies.
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