食管胃结合部腺癌（AEG）与传统意义上的食管癌及胃癌存在较大差异。随着对其淋巴结转移规律的总结和认识，目前认为仅对于以纵隔淋巴结转移为主的Siewert I型AEG，经胸或左胸腹联合切口可作为其推荐的手术入路。对于以腹腔淋巴结转移为主的Siewert Ⅱ/Ⅲ型AEG，经胸入路及胸腹联合入路与开腹手术相比手术风险大、住院时间延长，且不改善病人长期存活率。由于较少合并纵隔淋巴结转移，经腹入路可作为Siewert Ⅱ/Ⅲ型肿瘤合理的手术选择。

Reasonable option of surgical approach for adenocarcinoma of the esophagogastric junction        SUO Jian, WANG Da-guang, XIA Ming-jie. Department of General Surgery, the First Hospital of Jilin University, Changchun 130021, China
Correspongding author:SUO Jian,E-mail: suojian0066@yahoo.com.cn
Abstract    Compared with traditional esophageal and gastric cancer， adenocarcinoma of the esophagogastric junction （AEG） is quite different. The transthoracic or left thoraco-abdominal incision can only be used as the recommended surgical approach for type I AEG with mediastinal lymph node metastasis. For type Ⅱ/Ⅲ AEG with abdominal lymph node metastasis, the transthoracic and thoraco-abdominal approach can increase the operative risk, prolong hospitalization and can not improve long-term survival of patients compared with abdominal approach. For type Ⅱ/Ⅲ AEG with fewer mediastinal lymph node metastasis, abdominal approach is a reasonable surgical option.