Surgical Strategies for Adenocarcinoma of the Esophagogastric Junction

Chapter
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 182)

Abstract

This chapter summarizes the surgical strategies for adenocarcinomas of the distal esophagus, gastric cardia, and subcardial gastric cancer invading the cardia ± distal esophagus known as adenocarcinomas of the esophagogastric junction (AEG). The different surgical approaches according to the tumor origin, localization, and tumor stage are addressed with particular attention to the extent and type of resection and appropriate lymphadenectomy (LAD). The classification of AEG according to Siewert is helpful for the selection of the surgical strategy. While type I tumors benefit from a transthoracic en bloc esophagectomy including a two-field LAD, type II and III tumors can be treated by an extended total gastrectomy with a transhiatal resection of the distal esophagus and LAD of the lower mediastinum and the abdominal D2 compartment. Limited resections appear to be ­possible for early tumor stages in selected cases of type I–III tumors.

Keywords

Endoscopic Mucosal Resection Distal Esophagus Limited Resection Laparoscopic Total Gastrectomy Jejunal Interposition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospital ZurichZurichSwitzerland

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