臨床外科68巻4号

2013年04月発行

特集 「食道胃接合部癌」に迫る！

各論

食道胃接合部癌に対するリンパ節郭清と予後

著者： 黒川幸典¹ 瀧口修司¹ 森正樹¹ 土岐祐一郎¹

所属機関： ¹大阪大学大学院医学系研究科外科学講座消化器外科学

ページ範囲：P.430 - P.433

文献概要

【ポイント】

◆食道胃接合部癌は，Siewert type別にリンパ節転移の好発部位が異なる．

◆Siewert Ⅰ型は中・下縦隔リンパ節転移が高頻度であるため，右開胸アプローチによる中・下縦隔の郭清効果が期待されるが，Siewert Ⅱ型とⅢ型は開腹経食道裂孔アプローチによる下縦隔郭清のみで十分と考えられる．

◆Siewert Ⅰ型とⅡ型では，胃の領域リンパ節のうち#4sb，4d，5，6への転移は非常に稀であるため，これらの郭清は不要と考えられる．

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