Surgical approach to advanced Siewert II cancer: beyond the borders? The West Side

The surgical approach to Siewert type II cancer should be individualized as there is no one size fits all option. Criteria for individualization are epidemiological, functional, oncologic and surgical items. However, our preferred procedure for advanced adenocarcinoma of the esophagogastric junction type II is esophagectomy, if this or transhiatal extended gastrectomy are both possible with R0 resection. Esophagectomy has the advantages of a longer esophageal safety margin, complete mediastinal lymphadenectomy, easier anastomosis, routine minimal invasive gastrolysis with abdominal lymphadenectomy and preservation of a gastric reservoir.

Automated summary

The surgical approach for Siewert type II cancer should be personalized based on individual characteristics such as epidemiological, functional, oncologic, and surgical factors. For advanced adenocarcinoma of the esophagogastric junction type II, our preferred procedure is esophagectomy, with the option of transhiatal extended gastrectomy if R0 resection can be achieved. Esophagectomy offers several advantages.