SPractice of individualized surgical treatment for adenocarcinoma of esophagogastric junction

The incidence of adenocarcinoma of esophagogastric junction (AEG) has been rising year by year. Because its management spans both thoracic and general surgery, there are notable differences in surgical approaches, the extent of lymph node dissection, and digestive tract reconstruction. Lymph node dissection is central to curative surgery for AEG. While achieving an R₀ resection, surgical planning should also balance preservation of gastrointestinal function and control of complications, with judicious selection of the digestive tract reconstruction method. The authors summarize their institutional practice regarding the selection of operative extent and reconstruction for AEG. They emphasize an esophageal invasion length (EIL)≥3 cm as a key criterion for adopting a transthoracic approach with mediastinal lymph‑node dissection, and prioritize gastric function-preserving reconstruction whenever feasible, providing systematical experience.