【评论】腹腔镜左半结肠切除术治疗结肠脾曲癌过程中被忽视血管的识别和处理  

[Comment]Unveiling the hidden:identification and management of overlooked blood vessels in laparoscopic left hemicolectomy for splenic flexure cancer

作　　者：王枭杰[1] Wang Xiaojie

机构地区：[1]福建医科大学附属协和医院结直肠外科,福建福州350001

出　　处：《结直肠肛门外科》2025年第1期63-64,共2页Journal of Colorectal & Anal Surgery

摘　　要：背景在腹腔镜左半结肠切除手术中,胃结肠韧带靠近脾门区域存在一条常被忽视的较粗血管,可能引发术后出血等并发症。本研究旨在探索这一条血管的识别与处理方法。方法本研究是一项在中国国家级胃肠外科中心进行的回顾性、描述性研究,纳入了2021年1月至2023年7月间接受腹腔镜左半结肠切除术治疗34例结肠脾曲癌患者的临床资料。所有手术均采用我们提出的“五步法”进行。结果采用“五步法”能够有效地暴露这条血管。研究发现,这条血管在所有患者中恒定出现,其实际上是胃网膜左动脉和静脉的网膜分支。结论本研究明确了这条被忽视血管的来源,并推荐了一种安全的手术处理方法。这可能对进行腹腔镜左半结肠切除术以治疗结肠脾曲癌的结直肠外科医师有所助益。Background During laparoscopic left hemicolectomy procedures,a previously overlooked consistently thick blood vessel within the gastrocolic ligament near the splenic hilum may contribute to post-operative bleeding complications.The purpose of this study was to investigate the identification and management of the previously overlooked blood vessel.Methods This is a retrospective descriptive study of patients undergoing laparoscopic left colectomy for splenic fexure cancer conducted at a national gastrointestinal surgery centre in China.Consecutive patients with splenic fexure cancer who underwent laparoscopic left colectomy using our“five-step process”(n=34)between January 2021 and July 2023 were included.Results The vessels can be effectively exposed using the aforementioned“five-step process”.It was observed that the overlooked vessels consistently present in all patients were identified as the omental branch of the left gastroepiploic artery and vein.Conclusion We have identified the origin of previously overlooked blood vessels and recommended a safe method for their management.This may offer advantages to colorectal surgeons performing laparoscopic left colectomy for splenic flexure cancer.

关 键 词：结肠脾曲癌 腹腔镜左半结肠切除术 被忽视的血管 

分 类 号：R735.3[医药卫生—肿瘤]