胃结肠静脉干解剖学研究的系统评价及其临床意义  

Anatomy and clinical significance of the gastrocolic venous turnk:a meta-analysis

作　　者：赵丽瑛 张策 李国新 

机构地区：[1]南方医学大学南方医院普通外科,广东广州510515

出　　处：《中国实用外科杂志》2012年第9期753-757,共5页Chinese Journal of Practical Surgery

基　　金：广东省自然科学基金(07300474);广东省科技计划项目(2008A030201017)

摘　　要：目的荟萃分析胃结肠静脉干的组成形式、出现概率及其属支构成比例,强调其在临床手术尤其是腹腔镜扩大右半结肠癌D3根治术中的意义。方法计算机检索中国生物医学文献数据库(CBMdisc)、维普中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数据库(WF)、PubMed和EMbase,辅以手工检索,收集统计描述胃结肠干及肠系膜上静脉解剖学研究的文献,按照纳入标准由两名研究者独立筛选试验并提取资料,按新的分类方法统计胃结肠静脉干的组成形式。结果胃结肠静脉干的总出现率为89.1%。胃结肠干、胃胰干、胃胰结肠干的出现率分别为24.8%、16.8%和52.6%。胃结肠干的主要组成形式是右结肠静脉和胃网膜右静脉两支合干。在胃胰干的胰十二指肠前静脉属支中,胰十二指肠上前静脉比胰十二指肠下前静脉更常见。胃胰结肠干的出现率最高,其属支构成复杂,以右结肠静脉、胃网膜右静脉和胰十二指肠前静脉三支合干的构成形式为主。胃结肠静脉干平均外径为5.0(2～10)mm,平均长度为14.0(2～47)mm。结论绝大多数人体中存在胃结肠静脉干,按照器官来源和临床应用将其分为三类,胃胰结肠干是最常见的一类。牢固掌握胃结肠静脉干的解剖学分布对临床手术尤其是腹腔镜扩大右半结肠切除术有重要意义。Objective The aim of this study was to describe the anatomy of the gastrocolic venous trunk based on the literatures, emphasize its significance in surgery especially in laparoscopic extend fight hemicolectomy. Methods Databases as CNKI, CBM, VIP ,WF, PubMed and EMbase were searched for literatures on the description of the gartrocolic venous trunk or the tributaries of the superior mesenteric vein （SMV） to analyze the tributaries of the gartrocolic venous trunk in a new classification basing on the clinical application. Two researchers selected studies and extracted data independently using a designed extraction form. Results A total of 11 literatures involving 698 objects of study were enrolled in this study. The venous trunk was found in 622（89.1%） specimens and the gastrocolie trunk（GCT）, gastropanereatic trunk （GPT） and gastropancreaticocolie trunk （GPCT） were found in 24.8% ,16.8% and 52.6% respectively. The main tributary pattern of the GCT was the right colic vein （RCV） joining up with the right gastroepiploic vein （RGeV）. The GPCT was the most frequent component of the venous trunk. The mean caliber and length of the venous trunk were 5.0ram （range 2-10mm） and 14.0mm （ range 2-47mm）. Conclusions The gastrocolic venous trunk present in most of people. It can be classified in three types basing on the clinical significance. The GPCT was the most frequent one. Handing the anatomy of the gastrocoliv venous trunk is very important to operation, especially to laparoscopie extend right hemicolectomy.

关 键 词：解剖 胃结肠静脉干 胃胰结肠干 腹腔镜扩大右半结肠切除术 

分 类 号：R6[医药卫生—外科学]