“系膜化”切除和“膜解剖”理念在胃癌根治术中的解剖学探索

Anatomical exploration for "mesangization" resection and "membrane anatomy" in gastric cancer radical surgery

  • 摘要: 胃癌的手术治疗经过30余年的规范化探索,已经从早期的切除,经扩大化切除发展到现今更精确的个体化手术3.0阶段。该过程中不但有业界学者精益求精的科研精神与使命感,更得益于腹腔镜、机器人、生物工程、电子显示等技术的发展,同时提出了“微解剖”“膜解剖”“全系膜”“层面手术”等理念。上述理念也得到国内外学者的逐渐认可与重视,但不可避免在基础概念、实际操作中产生较多概念模糊、标准不统一、操作难规范等问题。笔者基于团队前期研究,联合山西医科大学基础医学院对胃癌的发生与解剖层面进行相关概念的规范探索并提出“系膜化”切除与6条系膜、8条血管筋膜缘的理念以供探讨。

     

    Abstract: After more than 30 years of standardized exploration, the surgical treatment of gastric cancer has developed from early resection to expanded resection, and to the current more accurate individualized surgery 3.0 stage. In this process, not only has the scientific research spirit and sense of mission of scholars in the industry to keep improving, but also benefits from the development of laparoscopy, robotics, bioengineering, electronic display and other technologies. The concepts of "microanatomy", "membrane anatomy", "mesangium" and "level operation" have been constantly proposed. These concepts have been gradually recognized and paid attention to by scholars at home and abroad, but inevitably in the basic concept and practical operation, there are many problems of fuzzy fields and standards are not uniform, and operation is difficult to standardize. Based on the previous research foundation of the team, the authors collaborate with the School of Basic Medicine of Shanxi Medical University to explore the normative concepts related to the occurrence and anatomy of the gastric cancer, and propose the concept of "mesangial" excision with 6 mesanges and 8 blood vessels fascia margins for discussion.

     

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