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Advances in the surgical treatment of esophageal cancer since 1965

机译:自1965年以来在食道癌外科治疗方面的进展

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摘要

In Japan, the treatment of esophageal cancer has undergone significant development since the Japanese Society for Esophageal Diseases was established in 1965 by Doctors Komei Nakayama, Shigetsugu Katsura, and Ichiro Akakura. When the Society was established, surgery was the first‐line treatment for esophageal cancer. Since then, the Society has been led by three successive chairpersons—Doctors Katsura, Nakayama, and Satoh. Over this time, surgery‐related mortalities declined to 5%‐6% because of the rapid improvements in surgical technique. Beginning in 1980, the bilateral cervical lymph node dissection technique gained attention, and favorable long‐term outcomes were gradually reported. A nationwide questionnaire survey, conducted by the Society in 1990, showed that more favorable long‐term outcomes were achieved by following the three‐field lymph node dissection technique than by following the two‐field lymph node dissection technique. Since then, the three‐field lymph node dissection technique has been recognized and widely used as the standard surgical procedure for treating esophageal cancer. After clinical studies examined the utility of various pre‐ and postoperative adjunctive therapies in outcome improvements, preoperative chemotherapy was recognized as the standard treatment in the therapy guidelines. Additionally, less invasive surgical methods have been developed, including endoscopic and robot‐assisted surgeries, which are applied in general practice now. However, unresectable and recurrent esophageal cancers remain difficult to treat, and additional treatments should be developed.
机译:在日本,自1965年由中山幸明博士,桂桂重久和赤仓一郎医生成立日本食道疾病学会以来,食道癌的治疗有了长足发展。学会成立后,手术是食道癌的一线治疗方法。从那时起,该学会由三位连续的主席-克苏拉,中山和佐藤博士领导。在这段时间内,由于手术技术的快速进步,与手术有关的死亡率下降到5%-6%。从1980年开始,双侧颈淋巴结清扫术引起了人们的关注,并逐渐取得了良好的长期效果。该学会在1990年进行的一项全国性问卷调查显示,采用三视野淋巴结清扫术比采用两视野淋巴结清扫术可获得更好的长期效果。从那时起,三视野淋巴结清扫技术已被公认并被广泛用作治疗食道癌的标准手术方法。在临床研究检查了各种术前和术后辅助疗法对改善结局的实用性之后,术前化学疗法被认为是治疗指南中的标准治疗方法。此外,已经开发了侵入性较小的外科手术方法,包括内窥镜和机器人辅助手术,这些方法现已在一般实践中应用。然而,无法切除和复发的食管癌仍然难以治疗,应开发其他治疗方法。

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