Principles of esophageal cancer surgery, including surgical approaches and optimal node dissection (2- vs. 3-field)
Principles of esophageal cancer surgery, including surgical approaches and optimal node dissection (2- vs. 3-field)
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DOI：
10.21037/acs.2017.03.04
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发表时间：
2017-03-01
影响因子：
3.1
通讯作者：
Lerut, Toni
中科院分区：
文献类型：
--
作者：
Nafteux, Philippe;Depypere, Lieven;Lerut, Toni
食管癌和胃食管连接部癌（GEJ）的手术被认为是消化道最复杂和最具挑战性的干预措施之一。这是由于与胸部重要结构的密切关系以及通过密集而复杂的粘膜下层网络进行早期淋巴播散的趋势。这篇综述文章根据不断发展的技术，特别是微创食管切除术（MIE），讨论了手术入路的不同方面。手术方法的各个方面与仍在进行的关于淋巴结清扫程度的辩论有着千丝万缕的联系，鉴于广泛应用的新辅助治疗方案以及术后生活质量方面的重要性日益增加，这一辩论正在获得一个新的层面。最后，作者提供了一个实用的和病人量身定制的方法，适用于他们的中心。
Surgery for esophageal carcinoma and carcinoma of the gastro-esophageal junction (GEJ) is considered as one of the most complex and challenging interventions on the digestive tract. This is due to the intimate relations with vital structures in the chest and the tendency of early lymphatic dissemination via a dense and complex submucosal network. This review article discusses the different aspects of surgical access routes in the light of the ever-evolving techniques, in particular the minimally invasive esophagectomy (MIE). The aspects of surgical approach are inextricably linked to the still ongoing debate on extent of lymphadenectomy, a debate that is obtaining a new dimension in view of the widely applied neoadjuvant therapy protocols as well as in view of the increasing importance of quality of life aspects after surgery. Finally, the authors provide a practical and patient tailored approach as applied in their center.