Tumor safety distances for esophageal cancer surgery

Radical surgery for esophageal cancer: It is the complete resection of esophageal cancer and its surrounding lymph nodes and reconstruction of the digestive tract. However, it should be noted that esophageal cancer is characterized by multiple points of origin of the lesions, and the incidence of multiple primary cancers of the esophagus in patients with esophageal cancer has been reported in the literature to range from 0.8% to 10.8%. When the esophagus was resected for 5CM next to the cancer, the cut end was still positive in 6.7% of cases. Early esophageal cancer often has infiltration of submucosal cancer tissue, and the scope of resection should be extensive. There is a view that the cancer infiltrates and spreads to the upper esophagus, the maximum length can be up to 10cm, and the infiltration to the lower esophagus is usually not more than 5cm, and if the upper end of the esophagus is not sufficiently resected, the anastomotic recurrence is easy to be caused. Therefore, it is suggested that all squamous cell carcinoma of the esophagus should be subtotal resection to reduce the residual cancer. Qin Jianjun, Department of Thoracic Surgery, Henan Cancer Hospital Nowadays, it is generally believed that it is not safe to resect the tumor 5cm away from the edge of the tumor that is visible to the naked eye. The minimum safe distance is recommended to be more than 8cm. Therefore, for lower thoracic esophageal cancer, esophagogastric anastomosis should be performed on the aortic arch or in the neck; for mid-thoracic esophageal cancer, esophagogastric anastomosis should be performed in the neck.