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Resultados de las diferentes opciones quirúrgicas para el tratamiento del cáncer de la unión esofagogástrica. Revisión de la evidencia
Institution:1. Section of General, Thoracic and Vascular Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, USA;2. Division of General Surgery, Department of Surgery, Royal Inland Hospital, University of British Columbia, 311 Columbia Street, Kamloops, British Columbia V2C 2T1, Canada;1. Sección de Cirugía esofagogástrica, Hospital Universitario Basurto, Bilbao, Spain;2. Sección de Cirugía esofagogástrica, Hospital Universitario Donostia, Donostia-San Sebastián, Spain;3. Sección de Cirugía esofagogástrica, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
Abstract:There is significant controversy in the management of cardiac cancer. It seems unanimous that Siewert type I tumors be operated on as cancer of the esophagus and Siewert type III as gastric cancer. However, for “true” cancer of the gastric cardia or Siewert II, the authors do not agree. There is the obvious need for free proximal and distal margins, as well as correct lymphadenectomy. For some, esophagectomy is necessary to perform correct radical oncological surgery, but other authors defend that an abdominal approach is sufficient to perform total gastrectomy and distal esophagectomy. Recent and older papers published do not clarify this issue, and their results are contradictory. Chemotherapy prior to surgery can reduce the size of the tumor and the presence of lymphadenopathies.
Keywords:Esophagus  Stomach  Cardia  Siewert  Esophagectomy  Gastrectomy
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