Page 124 - Read Online

Li et al. Mini-invasive Surg 2019;3:15 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.13

Commentary Open Access

Siewert type II adenocarcinoma of esophagogastric
junction: treatment status

Shu-Chun Li , Lu Zang 1,2
1,2
1 Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
2 Shanghai Minimally Invasive Surgery Center, Shanghai 200025, China.

Correspondence to: Dr. Lu Zang, Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,
197 Ruijin Er Road, Shanghai 200025, China. Shanghai Minimally Invasive Surgery Center, Shanghai 200025, China.
E-mail: zanglu@yeah.net

How to cite this article: Li SC, Zang L. Siewert type II adenocarcinoma of esophagogastric junction: treatment status. Mini-
invasive Surg 2019;3:15. http://dx.doi.org/10.20517/2574-1225.2018.13

Received: 31 Dec 2018 First Decision: 25 Mar 2019 Revised: 8 Apr 2019 Accepted: 17 Apr 2019 Published: 15 May 2019

Science Editor: Tetsu Fukunaga Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
The incidence of adenocarcinoma of esophagogastric junction (AEG) has been increased continuously in the past
decades, especially in western countries. Siewert type II is regard as the true AEG because of its location, however,
the treatment for Siewert type II AEG has not reached a consensus in the academic. According to published studies
nowadays, this commentary will introduce the surgical strategies and put forward suggestions for Siewert type II
AEG in several aspects as follows: (1) optimal surgical approach; (2) optimal extent of lymph node dissection; (3)
reconstruction methods. With the development of minimally invasive surgery, many experienced surgeons perform
esophagogastrostomy via transhiatal approach. Moreover, many details during the surgery still need further research by
cooperation between different departments and even countries.

Keywords: Esophagogastric junction, adenocarcinoma, surgical approach, reconstruction

INTRODUCTION
The incidence of adenocarcinoma of esophagogastric junction (AEG) has been increased continuously
[1,2]
in the past decades, especially in western countries . AEG refer to the adenocarcinoma which straddle
the gastroesophageal junction (EGJ). EGJ is the region where the esophagus joins the stomach . There
[3]
are different methods to identify the EGJ including surgical, physiology, histology, endoscopy or upper
[4,5]
gastrointestinal imaging . In terms of conveniences, the surgeons usually regard the boundary of the
tubular esophagus and the saccular stomach as EGJ in the surgery.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.misjournal.net