膜解剖理论对胃癌根治术中关键技术的应用指导及实践妥协  

Application of membrane anatomy in key technologies during gastric cancer surgery: guidance and compromise

作　　者：沈健[1] 张建平[1] Shen Jian;Zhang Jianping(Department of General Surgery,the Second Affiliated Hospital,Nanjing Medical University,Nanjing,Jiangsu 210011,China)

机构地区：[1]南京医科大学第二附属医院普通外科,210011

出　　处：《中华胃肠外科杂志》2020年第7期648-652,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金面上项目(81874058);江苏省卫健委"十三五强卫工程"青年医学重点人才项目(QNRC2016673)。

摘　　要：与仅仅关注人体器官组织形态结构的经典手术解剖学不同,现代膜解剖既关注形态结构关系及其如何发生,同时又关注肿瘤生物学行为特点,是从结构关系与疾病功能两方面进行整体解读的理论体系,因此得到诸多胃肠外科医生的认同。但胃的膜解剖理论体系尚未完善,胃及其系膜在胚胎发育过程中经历了复杂的旋转与融合,以致外科医生对胃的膜解剖的认识和理解各有不同,在实践中也存在各种混淆与误解,导致膜解剖的理论与手术实践产生偏差。本文将胃系膜分成不同区域,回溯胚胎发育过程,结合手术实践中的思考与理解,阐述膜解剖理论在胃癌根治术中的应用指导及实践妥协问题。Different from classical surgical anatomy which only pays attention to the morphology and structure of human organs,modern membrane anatomy focuses on not only the relationship between morphology and structure,but also the biological behavior characteristics of tumors.Membrane antomy is a theoretical system with interpretation on both the structural and disease function,so it has been accepted by more and more gastrointestinal surgeons.However,the theoretical system of gastric membrane anatomy is not mature yet.The stomach and its mesentery have undergone complex rotation and fusion in the process of embryonic development,so that surgeons have different understandings of the gastric membrane anatomy.Therefore,it is easy to cause various confusion and misunderstanding,resulting in deviations between the theory of membrane anatomy and the practice of surgery.In the present study,the mesentery of the stomach is divided into different regions,and the embryonic development process is traced back.The application and compromise encountered in the radical gastrectomy of gastric cancer will be expounded according to the membrane anatomy theory combined with the author's experience of operation.

关 键 词：胃癌根治术 胃肠外科 人体器官 组织形态结构 经典手术 外科医生 膜解剖 胃系膜 

分 类 号：R735.2[医药卫生—肿瘤]