摘要食管癌是常见恶性肿瘤之一,尽管多学科治疗手段提高了食管癌的预后,但其病死率仍较高,因为食管癌淋巴结转移可首先出现在颈部至腹部,所以采取了扩大淋巴结清扫的策略;三野淋巴结清扫术(3FLD)建立于20世纪80年代的日本,定义为一种经胸食管切除术,其进行颈-胸-腹三野淋巴结清扫,目前其被全世界广泛接受.迄今为止,已经报道各种关于3FLD和二野淋巴结清扫术(2FLD)的对比试验,并且证明3FLD在预后方面优于2FLD.但是,在3FLD中出现众多术后并发症如喉返神经损伤和术后胃肠道功能紊乱.近来,食管癌术前治疗的功效得到报道,微创手术的重要性也正在得到验证.术前治疗和可行的手术方法相结合,其将在未来不断提高食管癌患者的预后.

abstractsEsophageal cancer is a common malignancy worldwide.Although multidisciplinary treatment has improved the prognosis of esophageal cancer,its fatality rate remains high.Since lymph node metastases can primarily occur from the cervical to the abdominal field,a strategy for extended lymph node (LN) dissection has been established.The three-field LN dissection (3FLD) during a transthoracic esophagectomy which is defined as a procedure for cervico-thoraco-abdominal LN dissection,was established in the 1 980 s' in Japan,and is currently widely accepted throughout the world.To date,various comparative trials between 3FLD and two-field LN dissections (2FLD) have been reported and showed that a transthoracic esophagectomy with 3FLD is superior to 2FLD for prognosis.However,in 3FLD,postoperative complications,such as recurrent laryngeal nerve palsy and postoperative gastrointestinal dysfunction can be induced.Recently,the efficacy of intense perioperative treatment for esophageal cancer has been reported,and the significance of minimally invasive surgical procedures is being verified.The ideal combination of perioperative treatment and feasible surgery must be established to improve the oncological outcome of esophageal cancer patients further.