食管胃结合部腺癌的手术原则

食管胃结合部腺癌（AEG）在欧美地区急剧增加，引起世界范围的高度关注。我国虽有散见的相关研究报道，但对AEG治疗现状的把握是困难的。目前对AEG的规范化治疗正在逐渐形成共识。早期AEG的治疗是以内镜下黏膜切除术（EMR）、内镜黏膜下剥离术（ESD）、腹腔镜下手术、缩小手术为主。进展期AEG的治疗，SiewertⅠ型患者作为食管癌处理，开胸手术、纵隔淋巴结清扫可获得良好的预后效果；SiewertⅡ、Ⅲ型患者行开胸手术获益少，作为胃癌手术清扫更为妥当，经腹食管裂孔扩大、下段食管切除、全胃切除、下纵隔腹腔淋巴结（D：）清扫。

Principle of surgical treatment of adenocarcinoma of theesophagogastric junction

The incidence of adenocarcinoma of the esophagogastric junction （AEG） dramatically increased in the America and Europe. Although some search results on AEG have been reported, it is still difficult to elucidate the clinical status of AEG in China. The consensus of standardized treatment of AEG is gradually formed. For early AEG, endoscopic mucosal resection, endoscopic submucosal dissection, laparoscopic sur- gery and minimally extent surgery were the main treatment meth- ods; for advanced AEG, transthoracic esophagectomy or media- stinal lymph node dissection can offer beneficial prognosis for patients with Siewert type I AEG, while extended total gastrec- tomy, extended esophagogastrectomy, D2 lymph node dissection are appropriate for patients with Siewert type II and llI AEG.