Cao Y W, Chen X L, Yang K
Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Sep 25;27(9):909-913. doi: 10.3760/cma.j.cn441530-20240710-00240.
The incidence of esophagogastric junction adenocarcinoma is increasing gradually. The surgical procedures mainly include radical resection of the primary tumor, lymph node dissection, and digestive tract reconstruction. Due to the special anatomical location of esophagogastric junction adenocarcinoma, the pattern of lymph node metastasis is not clear, and regional lymph nodes dissection especially in the lower mediastinum is still controversial, and awaits further high-quality evidence. Meanwhile, due to the special anatomical location of the lower mediastinum, it is often difficult to perform lower mediastinal lymph node dissection. How to complete the lower mediastinal lymph nodes dissection more safely and effectively is the key point for gastric cancer surgeons. In this paper, the progress, consensus, and controversy on the extent of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma were discussed. Based on our own experience, the current clinically techniques for lower mediastinal lymph nodes dissection were summarized to further improve the quality control of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma.
食管胃交界腺癌的发病率正在逐渐上升。手术方式主要包括原发肿瘤的根治性切除、淋巴结清扫以及消化道重建。由于食管胃交界腺癌特殊的解剖位置，其淋巴结转移模式尚不明确，尤其是下纵隔区域的淋巴结清扫仍存在争议，有待进一步高质量证据支持。同时，由于下纵隔特殊的解剖位置，进行下纵隔淋巴结清扫往往较为困难。如何更安全有效地完成下纵隔淋巴结清扫是胃癌外科医生的关键要点。本文讨论了食管胃交界腺癌患者下纵隔淋巴结清扫范围的进展、共识及争议。基于我们自身的经验，总结了目前临床上进行下纵隔淋巴结清扫的技术，以进一步提高食管胃交界腺癌患者下纵隔淋巴结清扫的质量控制。
