国际肿瘤学杂志 ›› 2025, Vol. 52 ›› Issue (5): 262-267.doi: 10.3760/cma.j.cn371439-20250410-00045

• 中华医学会成立110周年 • 上一篇    下一篇

食管癌外科治疗述评

何文武, 韩泳涛()   

  1. 电子科技大学附属肿瘤医院/四川省肿瘤医院胸外科,成都 610041
  • 收稿日期:2025-04-10 修回日期:2025-04-20 出版日期:2025-05-08 发布日期:2025-06-24
  • 通讯作者: 韩泳涛 E-mail:yongtao_han@126.com

Surgical treatment for esophageal cancer: a comprehensive narrative review

He Wenwu, Han Yongtao()   

  1. Department of Thoracic Surgery, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Sichuan Cancer Hospital & Institute, Chengdu 610041, China
  • Received:2025-04-10 Revised:2025-04-20 Online:2025-05-08 Published:2025-06-24
  • Contact: Han Yongtao E-mail:yongtao_han@126.com

摘要:

食管癌是全球高发且预后较差的消化系统恶性肿瘤,手术切除仍是可切除患者实现长期生存的关键治疗方式。当前外科技术正从传统开放术式向微创胸腹腔镜手术和机器人辅助手术不断演进。多学科综合治疗理念推动新辅助放化疗及免疫治疗在食管癌围手术期的深度融合,使其治疗模式趋于标准化与个体化并重。围手术期管理的持续优化、加速康复路径的应用显著加速了食管癌患者的术后恢复,术后常见并发症的防控策略亦日益规范。食管癌术式的选择日趋精准,需综合考虑肿瘤部位、组织学类型及患者个体因素,术中导航、人工智能辅助决策、生物标志物与免疫微环境整合等新技术的应用不断拓展精准外科的边界。食管癌的外科治疗正在向微创化、智能化、系统协同的方向快速发展,有望进一步提升治疗的安全性、规范性与长期疗效。

关键词: 食管肿瘤, 外科手术, 肿瘤辅助疗法, 综合疗法

Abstract:

Esophageal cancer is a highly prevalent and poorly prognostic malignant tumor of the digestive system worldwide. Surgical resection remains the key treatment for achieving long-term survival in patients with resectable disease. Surgical techniques are evolving from traditional open approaches to minimally invasive thoraco-laparoscopic procedures and robot-assisted surgeries. The concept of multidisciplinary comprehensive treatment has facilitated the deep integration of neoadjuvant chemoradiotherapy and immunotherapy into the perioperative setting, making the treatment model tend to attach equal importance to standardization and individualization. The continuous optimization of perioperative management and the application of enhanced recovery pathways have significantly accelerated the postoperative recovery of patients with esophageal cancer, and the prevention and control strategies for common postoperative complications have also become increasingly standardized. The choice of surgical methods for esophageal cancer is becoming increasingly precise, requiring comprehensive consideration of tumor location, histological type, and patient-specific factors. The application of new technologies such as intraoperative navigation, artificial-intelligence-assisted decision-making, biomarker analysis, and immune microenvironment integration continues to expand the scope of precision surgery. The surgical treatment of esophageal cancer is developing rapidly in the direction of minimally invasive, intelligent and systematic collaboration, with the potential to further improve the safety, standardization, and long-term efficacy of the treatment.

Key words: Esophageal neoplasms, Surgical procedures, operative, Neoadjuvant therapy, Combined modality therapy