Reflux esophagitis, high-grade neoplasia, and early Barrett's carcinoma-what is the place of the Merendino procedure?

被引：11

作者：

Hoelscher, A. H. ^{[1
]}

Vallboehmer, D. ^{[1
]}

Gutschow, C. ^{[1
]}

Bollschweiler, E. ^{[1
]}

机构：

[1] Univ Cologne, Dept Gen Visceral & Canc Surg, D-50937 Cologne, Germany

来源：

LANGENBECKS ARCHIVES OF SURGERY | 2009年 / 394卷 / 03期

关键词：

Reflux esophagitis; Barrett's esophagus; Neoplasia; Early carcinoma; Merendino operation; LYMPH-NODE METASTASIS; VAGAL-SPARING ESOPHAGECTOMY; LONG-TERM; EARLY ADENOCARCINOMA; INTRAMUCOSAL ADENOCARCINOMA; ESOPHAGOGASTRIC JUNCTION; ENDOSCOPIC RESECTION; INCREASING INCIDENCE; ANTIREFLUX SURGERY; SURGICAL-TREATMENT;

D O I：

10.1007/s00423-008-0429-9

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Because of the increasing frequency of Barrett's cancer in Western industrialized countries, the management of reflux disease with the potential development of Barrett's esophagus, neoplasia, and early carcinoma is very important. In case of established Barrett's esophagus, the malignant degeneration of the specialized epithelium cannot definitely be prevented by antireflux surgery or continuous medication. Mucosal adenocarcinomas nearly never develop lymph node metastasis and can mostly be treated by endoscopic mucosectomy. The deeper the submucosa is infiltrated, the higher is the rate of lymph node metastasis which is, on the average, 30% for submucosal carcinoma. Therefore, radical subtotal esophagectomy is the treatment of choice for submucosal carcinoma, whereas distal esophageal resection with limited lymph node dissection is only indicated in mucosal carcinoma which cannot be completely removed by interventional endoscopy.

引用

页码：417 / 424

页数：8

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