[Thinking about the extent and technique of lower mediastinal lymph nodes dissection for adenocarcinoma of esophagogastric junction].

Abstract

The incidence of esophagogastric junction adenocarcinoma is increasing gradually. The surgical procedures mainly include radical resection of the primary tumor, lymph node dissection, and digestive tract reconstruction. Due to the special anatomical location of esophagogastric junction adenocarcinoma, the pattern of lymph node metastasis is not clear, and regional lymph nodes dissection especially in the lower mediastinum is still controversial, and awaits further high-quality evidence. Meanwhile, due to the special anatomical location of the lower mediastinum, it is often difficult to perform lower mediastinal lymph node dissection. How to complete the lower mediastinal lymph nodes dissection more safely and effectively is the key point for gastric cancer surgeons. In this paper, the progress, consensus, and controversy on the extent of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma were discussed. Based on our own experience, the current clinically techniques for lower mediastinal lymph nodes dissection were summarized to further improve the quality control of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma.