基于血管导向的膜解剖层面下腹腔镜远端胃癌根治术要点与盲点  

Key points and blind spots of laparoscopic radical distal gastrectomy based on vascular guidance and membrane anatomical planes

作　　者：李浩[1] 刘沛华 张泉涌 叶再生[2] 厉周[1] 韩帅[1] Li Hao;Liu Peihud;Zhang Quanyong;Ye Zaisheng;Li Zhou;Han Shuai(Department of General Surgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510000,Guangdong,China;Department of Gastric Surgery,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital(Fujian Hospital of Fudan University Cancer Hospital),Fuzhou 350014,Fujian,China)

机构地区：[1]南方医科大学珠江医院普通外科,广东广州510000 [2]福建医科大学肿瘤临床医学院,福建省肿瘤医院(复旦大学附属肿瘤医院福建医院)胃外科,福建福州350014

出　　处：《消化肿瘤杂志(电子版)》2025年第1期27-33,共7页Journal of Digestive Oncology(Electronic Version)

摘　　要：全球胃癌发病率虽然呈下降趋势,但中国仍面临较高的发病和死亡负担,迫切需要优化早期筛查和综合防控策略。基于血管导向的膜解剖层面的腹腔镜远端胃癌根治术,可以提高手术的精确性和安全性,减少了术中出血和副损伤,改善了患者的预后。然而,手术过程中存在诸多盲点需要克服,以进一步提高手术效果和患者的治愈率。本文详细探讨了基于血管导向的膜解剖层面下腹腔镜远端胃癌根治术的要点与盲点,强调了精确识别和切开膜桥的重要性,以及克服手术盲点的多种策略,旨在为胃癌的临床治疗提供更精准有效的操作指导,从而提高手术治愈率并减少术后并发症。Although the global incidence of gastric cancer is on a downward trend,China stll faces a high burden of morbidity and mortality,urgently requiring the optimization of early screening and comprehensive prevention and control strategies.Laparoscopic radical distal gastrectomy based on the vascular-oriented membrane anatomy can improve the accuracy and safety of the surgery,reduce intraoperative bleeding and collateral damage,and improve the prognosis of patients.However,there are still many blind spots during the operation that need to be overcome to further enhance the surgical outcome and the cure rate of patients.This article elaborates on the key points and blind spots of laparoscopic radical distal gastrectomy based on the vascular-oriented membrane anatomy,emphasizing the importance of accurately identifying and cutting the membrane bridge,as well as various strategies to overcome surgical blind spots.The aim is to provide more precise and effective operational guidance for the clinical treatment of gastric cancer,thereby increasing the surgical cure rate and reducing postoperative complications.

关 键 词：腹腔镜远端胃癌根治术 血管导向 膜解剖层面 手术要点 手术盲点 

分 类 号：R735.2[医药卫生—肿瘤]