“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 gastriccancer radical surgery

作　　者：陶凯 张卫国[2] 翟刚 任一鹏 王尔黎 陆利[2] 高泽锋 Tao Kai;Zhang Weiguo;Zhai Gang;Ren Yipeng;Wang Erli;Lu Li;Gao Zefeng(Department of Hepatobiliary,Pancreatic and Gastric Surgery,Shanxi Cancer Hospital,Shanxi Hospital of Cancer Hospital Chinese Academy of Medical Sciences,Shanxi Gastric Cancer Center,Taiyuan 030013,China;Department of Anatomy,School of Basic Medicine,Shanxi Medical University 030001)

机构地区：[1]中国医学科学院肿瘤医院山西医院,山西省肿瘤医院肝胆胰胃外科山西省胃癌中心,太原030013 [2]山西医科大学基础医学院解剖教研室,太原030001

出　　处：《中华消化外科杂志》2024年第3期360-366,共7页Chinese Journal of Digestive Surgery

基　　金：山西省科技厅社发项目(201803D32100086040709060380041191);中国医学科学院肿瘤医院山西医院博士人才启航基金(QH2023003)。

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。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.

关 键 词：胃肿瘤 系膜化切除 膜解剖 外科手术 解剖学 

分 类 号：R735.2[医药卫生—肿瘤]