基于肠系膜理念的克罗恩病外科治疗的研究进展  

Progress in the study of the surgical management of Crohn disease based on the mesenteric concept

作　　者：兰平[1] 张宗进 何真[1] Lan Ping;Zhang Zongjin;He Zhen(Department of General Surgery(Colorectal Surgery),the Sixth Affiliated Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Biomedical Innovation Center,the Sixth Affiliated Hospital,Sun Yat-sen University,Key Laboratory of Human Microbiome and Chronic Diseases(Sun Yat-sen University),Ministry of Education,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院普通外科(结直肠外科),广东省结直肠盆底疾病研究重点实验室,广州市黄埔区中六生物医学创新研究院,人体微生态与老年慢性疾病教育部重点实验室,广州510655

出　　处：《中华外科杂志》2025年第2期107-113,共7页Chinese Journal of Surgery

基　　金：国家重点研发计划(2022YFA1304000);国家自然科学基金重点联合项目(U21A20344)。

摘　　要：近年来, 随着对肠系膜研究的深入, 发现其血管、神经、淋巴组织、脂肪组织等结构在克罗恩病的发生和发展过程中发挥重要作用, 且病变程度与疾病进展、手术难度、术中并发症的发生及术后复发相关。针对肠系膜病变优化的克罗恩病手术策略受到学界的广泛关注, 国内外多项回顾性研究发现扩大肠系膜切除和Kono-S吻合术可降低克罗恩病术后复发率, 但最新的前瞻性随机对照试验研究未取得预期结果, 基于肠系膜的手术策略仍缺乏证据, 需进一步研究明确其有效性和适用范围。本文总结肠系膜在克罗恩病外科治疗中的研究进展, 以期为克罗恩病外科规范治疗和研究提供新的思考和方向。In recent years,with the deepening of mesentery research,it is found that its blood vessels,nerves,lymphoid tissue,adipose tissue and other structures play an important role in the occurrence and development of Crohn disease,and the degree of lesion is related with the disease process,surgical difficulty,the occurrence of intraoperative complications and postoperative recurrence.The optimal surgical strategy of Crohn disease based on mesenteric involvement has received great attention.Multiple retrospective studies found that extended mesenteric resection and Kono-S anastomosis potentially could reduce the rate of postoperative recurrence.However,the latest prospective randomized controlled studies did not achieve the expected results,and the evidence for the surgical strategy based on mesentery is still weak.This review summarises the findings of basic and clinical investigations of the mesentery in Crohn disease so far and explores its role in surgical treatment optimization,and provides new thinking and insights for the further research and surgical options for Crohn disease.

关 键 词：克罗恩病 肠系膜 扩大肠系膜切除 Kono-S吻合 术后复发 

分 类 号：R656.9[医药卫生—外科学]