编者按：2017国际胸外科学术大会（CITSAC）暨第五届国家癌症中心学术年会（NCCAC）期间，来自澳大利亚弗林德斯医学中心的Prof. David Watson进行了精彩的演讲。会后，我们十分荣幸地就食管癌手术治疗与管理的相关问题采访到了Prof. David Watson。
Professor David Watson graduated from the University ofAdelaide in 1984 and undertook training in General Surgery in South Australia,followed by Fellowships in Oesophago-Gastric Surgery at the Royal AdelaideHospital and the Royal Hallamshire Hospital in Sheffield, England. In 1994 hewas appointed to the Royal Adelaide Hospital as Director of the Royal AdelaideCentre for Endoscopic Surgery, and as Consultant Surgeon to theOesophago-Gastric Surgery Unit. In 2002 he was appointed Professor and Head of theflinders University Department of Surgery, and the Oesophago-Gastric SurgeryUnit at Flinders Medical Centre in Adelaide, South Australia.
He has clinical and research interests in the areas ofoesophageal and gastric disease, including gastro-oesophageal reflux and cancerof the oesophagus and stomach. He has been active in development oflaparoscopic and endoscopic surgery, and has led many landmark trials pertinentto this area. He also leads a basic science research group which isinvestigating the development of oesophageal cancer.
Professor Watson has published more than 300 research papersand book chapters, and he is on the Editorial Boards of leading Australian andInternational medical journals. He has been President of the Australian and NewZealand Gastric and Oesophageal Surgery Association, and has representedAustralia and New Zealand on the Board of Governors of the InternationalFederation of Societies for Endoscopic Surgery.
Since 1997 he has also received 16 major research grantsfrom NHMRC and NIH, as well as major grant support from other funding bodies.He has recently led Flinders University's engagement with Central SouthUniversity, in Changsha, China, and in 2014 was appointed an HonoraryProfessor, and Director of the Flinders Cancer Genetics Research Laboratory,based in Central South University, Changsha, China. In 2015 he was elected as aFellow of the Australian Academy of Health and Medical Sciences (FAHMS), andappointed a Matthew Flinders Distinguished Professor at Flinders University.
图1. 与Prof. Watson的合照
大会期间，Prof. Watson就“Avoiding problems after fundoplication –which antireflux operation?”——话题进行了精彩分享。关于胃底折叠术后常见问题以及应当选择何种抗反流手术，Prof. Watson认为，具体问题应当具体分析，复发性食管反流、术后并发症等不同问题应当采取不同的方式处理，而胃底折叠术的复杂性也造就了其复杂多样的影响因素与风险。
同时，Prof. Watson还就食管癌外科治疗热点话题分享了自己的看法——除了关于手术该如何进行等问题，Prof. Watson认为其中一个热点在于术后放疗与化疗应用方面的问题，这个在中国较为常见，因为据Prof. Watson分享，西方国家倾向于术前进行放化疗。此外，Prof. Watson认为另一个热点话题则是病人的选择——如何选择合适的病人以最小化风险应当我们一直要重视的问题。
对于近些年来食管癌治疗方面的进展，Prof.Watson认为其中最为明显的进展在于技术的进步，因为如今越来越多的手术会应用到微创技术。这些技术能减少并发症，加速康复，而对于这些技术，Prof. Watson则认为需要有对应的证据以及良好的试验证实其可行性。此外，Prof.Watson也提及到，在西方国家，现在的一个倾向是在很多末期食管癌病人的治疗方案中，化疗与放疗往往已是密不可分的。而对于早期食管癌，Prof. Watson表示则会倾向选择内窥镜治疗。
Today you share with us about “avoiding problems after fundoplication-which antireflux operation?”, here would you first share what’re the common problems after fundoplication? To different problems, which antireflux operation will you recommend?
During the section, Dr. Ferguson shared about the hot topics in surgical management of esophageal cancer. In your opinion, what are the hot topics in the surgical management of esophageal cancer?
Based on your experience, what do you think the progress for surgical management of esophageal cancer in recent years?
What do you think are the common mistake, error or challenges for young surgeons treating esophageal cancer based on the current situation?
You’re now a successful and well-known expert in the world. When looking back to the early experience as a young surgeon, what’d you like to say to yourself?
采写编辑：高凤平 李鹏程 AME Publishing Company
视频剪辑：麦雪芳 AME Publishing Company