食管癌外科治疗的现状与未来展望

摘要

Surgery is the main treatment of esophageal cancer. Esophagectomy by right transthoracic approach is recently recom-mended in China. Minimally invasive esophagectomy is feasible and safe with low perioperative morbidity and offers results that are as good as open thoractomy. Multimodal treatment, especially neoadjuvant chemoradiotherapy or chemotherapy, may improve surviv-al and has become one of the standard treatments for locally advanced esophageal cancer. Fast-track esophagectomy may reduce length of hospital stay, perioperative morbidity, and hospital charges. The surgery of esophageal cancer tends to be minimally invasive, individual, comprehensive, and standardized.%外科手术仍是治疗食管癌的最重要手段，近10年来国内推荐对胸段食管癌经右胸路径，并渐成共识；微创食管切除术（minimally invasive esophagectomy，MIE）安全可行，有利于减少术后并发症，完全可以与传统开胸手术媲美。应用综合治疗提高预后已见成效，术前放化疗和术前化疗成为当前主要手段。食管癌快速康复策略获得同行的高度关注与评价。食管癌外科趋向微创化、个体化、综合化和规范化的发展方向。