作者：王伟1，林泽宇2，罗立杰1，张子敬1，杨海淦1，于洋1，叶歆睿2，杨婷婷2

单位：1.广州中医药大学第一附属医院胃肠外科，广东 广州 510405；2.广州中医药大学第一临床医学院，广东 广州 510405

Authors: Wang Wei1, Lin Zeyu2, Luo Lijie1, Zhang Zijing1, Yang Haigan1, Yu Yang1, Ye Xinrui2, Yang Tingting2

Unit:  1.Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510405, Guangdong, China；2.The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China

摘要：

外科手术是Siewert Ⅱ型食管胃结合部腺癌的主要治疗方式，但该部位的肿瘤具有独特的解剖结构及生物学特征，导致其淋巴转移途径、肿瘤浸润范围等较复杂，为其手术方式、切除范围及消化道重建等带来挑战与争议。本文将围绕以上几点，基于现有的循证医学证据，结合自身临床经验及前期研究结果，探讨目前Siewert Ⅱ型食管胃结合部腺癌外科的治疗策略。

关键词： 食管胃结合部腺癌；Siewert Ⅱ型；淋巴结清扫；食管切除长度；消化道重建

Abstract：

Surgical intervention is the primary treatment option for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG). Nevertheless, the unique anatomy and biology of tumors in this region make lymphatic metastasis and tumor infiltration extent highly complex. Consequently, there are challenges and controversies regarding surgical methodology, resection range, and reconstruction of digestive tracts. In this article, we will probe the current surgical management of Siewert type Ⅱ AEG on the basis of available evidence-based medical evidence, our own clinical experience and previous research.

Key Words:  Adenocarcinoma of esophagogastric junction; Siewert type Ⅱ; Lymphadenectomy; Esophageal resection margin; Gastrointestinal reconstruction

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