Department of Surgery, Shintakeo Hospital, Tomioka 12628, Takeo Town, Takeo, Saga, 843-0024, Japan.
Kurume University, Fukuoka, Japan.
Gen Thorac Cardiovasc Surg. 2020 Oct;68(10):1187-1192. doi: 10.1007/s11748-020-01369-4. Epub 2020 Apr 29.
This report presents the essence in practice of Japanese methods and tradition in surgery for esophageal cancer.
The etiology of esophageal cancer and the concepts of lymphadenectomy in esophagectomy, in neoadjuvant treatments, and in stage classifications are compared between Western countries and Japan.
With respect to the type and relative incidence of esophageal cancer, in Western countries, adenocarcinoma in the lower thoracic esophagus and in the cardia is common, and among esophageal surgeons, there remains some controversy over the extent of lymphadenectomy. On the other hand, in Japan, squamous cell carcinoma in the middle thoracic esophagus is common, and concerning lymphadenectomy, Japanese esophageal surgeons consider that three-field lymphadenectomy is superior to other types of lymphadenectomy. In Japan, surgeons believe that most patients with esophageal cancer even those having lymph node metastasis can be best treated using esophagectomy and lymphadenectomy.
In Japan, the tradition in esophageal surgery places great significance on lymphadenectomy. The ways and procedures for esophageal cancer surgery, the neoadjuvant and adjuvant treatments, the Japanese Classification of Esophageal Cancer, the Esophageal Cancer Practice Guidelines, and other scientific reports are all based on a close combination of esophagectomy with lymphadenectomy.
本报告介绍了日本在食管癌外科中方法和传统的实践精髓。
比较了西方国家和日本在食管癌的病因学、食管癌切除术、新辅助治疗和分期分类中的淋巴结清扫概念。
在西方国家，下胸段食管和贲门的腺癌较为常见，食管外科医生对淋巴结清扫的范围仍存在一些争议。另一方面，在日本，中段食管的鳞状细胞癌较为常见，对于淋巴结清扫，日本食管外科医生认为三野淋巴结清扫优于其他类型的淋巴结清扫。在日本，外科医生认为，即使是有淋巴结转移的食管癌患者，也可以通过食管切除术和淋巴结清扫得到最佳治疗。
在日本，食管癌外科的传统非常重视淋巴结清扫。食管癌手术的方式和程序、新辅助和辅助治疗、日本食管癌分类、食管癌实践指南和其他科学报告都基于食管切除术和淋巴结清扫的紧密结合。
