Surgical resection for cancer of the cardia

摘要: From the pathogenic and therapeutic point of view, adenocarcinomas esophagogastric junction (AEG) should be classified into adenocarcinoma distal esophagus (Type I), true carcinoma cardia II), subcardial III). This classification can easily performed by summarizing information available from contrast radiography, endoscopy, intra-operative findings; it allows comparison data between various centers facilitates choice surgical therapy. A complete removal primary tumor its lymphatic drainage has to goal any approach junction. In patients with potentially resectable, (AEG Type this achieved a total gastrectomy transhiatal resection en bloc in lower posterior mediastinum along celiac axis superior border pancreas. is associated morbidity provides equal long-term survival as compared more radical transmediastinal or abdominothoracic esophagogastrectomy. Whether routine splenectomy for lymphadenectomy splenic hilus offers benefit these questionable. early tumors staged uT1 on pre-operative endosonography, limited proximal stomach, cardia, interposition pedicled isoperistaltic jejunal segment appears justified since procedure adequate lymphadenctomy excellent functional results. Multimodal therapy polychemotherapy combined radio-chemotherapy offer significant locally advanced tumors. With tailored approach, extensive staging becomes mandatory an selection appropriate concept.