[Standardized surgical procedure of laparoscopic transphrenic approach for Siewert TypeⅡ adenocarcinoma of esophagogastric junction (2024 edition)].

In recent years, with the popularization of minimally invasive surgery, laparoscopic transphrenic approach (LTP) surgery for Siewert Type II adenocarcinoma of esophagogastric junction (AEG) has gradually been applied in clinical practice. This technique combines the advantages of transthoracic and transabdominal approaches, achieving a combined operation of the thoracic and abdominal cavities. It can achieve thorough lymph node dissection, safe esophageal resection margin, and reliable digestive tract reconstruction, and has promising application prospects. However, there is no unified standard for LTP surgery at present, which hinders the standardization and further promotion of this technology. Therefore, the Oncology Gastroenterology Committee of China Anti-cancer Association has convened experts from domestic gastrointestinal and thoracic surgery fields, reviewed relevant literature, and combined with clinical practice. After extensive discussions, they formulated the LTP surgical operation standard. This standard encompasses various aspects, including the surgical approach, indications, contraindications, preoperative preparation, operational procedures (encompassing anesthesia, patient positioning, surgeon's stance, abdominal operation port layout, thoracic operation port layout, the Five-Step Maneuver lower mediastinal lymphadenectomy, and digestive tract reconstruction), as well as the prevention and management of specific complications. The aim is to provide a reference for clinical doctors conducting the Siewert Type II AEG radical surgery with LTP.