| Abstract: |
Despite the scarcity of level I evidence, many strongly held opinions persist regarding best practices for the surgical management of esophageal and gastroesophageal junction tumors. The range of opinions span from a seeming nihilism, wherein the role of esophagectomy is considered to be primarily palliative, to a belief in “radical” resections, wherein an en bloc esophagectomy constitutes the major componentof a curative treatment strategy. Fortunately, some data have accrued during the past decade that can help clarify at least some of the principle areas of importance in esophageal resection. This new knowledge includes clarifi cation of the variable risks of developing nodal disease, on the basis of tumor stage, and what role the assessed risk should play in the choice of operation, the importance of operative margins, and the oncologic implications of technical complications. In addition, there is now a betterunderstanding of what is truly necessary in an esophagectomy and what is lore. Ultimately, if these principles are considered when choosing a surgical approach, some of the controversies regarding esophagectomy should be resolved. © Springer International Publishing Switzerland 2015. |
