J.Jpn. Surg. Soc.. 116(1): 45-49, 2015

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Feature topic

ADVANTAGES AND PITFALLS OF MINIMALLY INVASIVE SURGERY FOR ESOPHAGOGASTRIC JUNCTION TUMORS

Several studies of minimally invasive esophagectomy (MIE) for esophagogastric junction (EGJ) tumors have been reported from Western countries with high incidences of lower esophageal cancer. Less invasiveness and a better quality of life after MIE compared with open esophagectomy were found in a randomized controlled trial in Europe. On the other hand, as laparoscopic total gastrectomy for upper gastric cancer has gradually become more common, laparoscopic transhiatal resection and reconstruction to treat EGJ tumors have been reported in Japan. Some potential benefits of laparoscopic total gastrectomy for upper gastric cancer, such as less blood loss and fewer complications, were indicated in comparative studies. Therefore, similar benefits are also expected for EGJ tumors, although there is no current evidence for this. It is difficult to determine which minimally invasive approach is better because the appropriate approach and extent of resection may differ depending on the location and size of each tumor. For the minimally invasive approach to the treatment of EGJ tumors to be accepted as an option, a safe reconstruction method with good long-term quality of life needs to be established.

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