Proximal segmentation of the dorsal mesogastrium reveals new anatomical implications for laparoscopic surgery.
Proximal segmentation of the dorsal mesogastrium reveals new anatomical implications for laparoscopic surgery.
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背侧中胃部的近端分割揭示了腹腔镜手术的新解剖学意义
DOI：
10.1038/srep16287
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发表时间：
2015-11-06
影响因子：
4.6
通讯作者：
Gong J
中科院分区：
文献类型：
--
作者：
Xie D;Gao C;Lu A;Liu L;Yu C;Hu J;Gong J
胃肠道肿瘤根治性手术的金标准通常伊森切除原发灶及其相关组织。对于胃癌，理想的手术方式应是D2根治性胃切除加全胃系膜切除。完全胃系膜切除术很少做或提及，因为很少有人知道胃系膜，它的存在仍然存在争议。在地形学上，“胃系膜”是指由“固有筋膜”组成的胃周结构，其包围淋巴结、血管和脂肪组织，其通过连接到胃，从后腹壁悬置。在本研究中，借由电视腹腔镜检查，我们发现胃系膜背侧的许多近端节段广泛地散布在胰脏周围。胃系膜的结构在术中进一步确定，然后在手术后进行大体和组织学确认。我们的结果证明了胃系膜（胃系膜）及其结构的存在。本文首次提出了一个描述胃与胃固有筋膜所包裹的胃系膜关系的“桌子模型”，这可能为胃癌手术方法的改进提供一个新的思路。
Generally, the gold standard of radical surgery for gastrointestinal (GI) tumors isen blocresection of primary lesions and their related tissues. For gastric cancer, the ideal surgical treatment should be D2 radical gastrectomy plus complete mesogastrium excision. Complete mesogastrium excision is rarely done or mentioned since little is known about the mesogastrium and its presence is still with controversy. Topographically, the “mesogastrium” refers to a peri-gastric structure composed of “fascia propria”, enveloping lymph nodes, blood vessels and adipose tissues, which by connecting to the stomach, suspends from the posterior abdominal wall. In this study, by employing video laparoscopy, a number of proximal segments of dorsal mesogastrium were found being extensively scattered around the pancreas. The structure of the mesogastrium was further identified intraoperatively and then confirmed both grossly and histologically after the operation. Our results demonstrated the existence of mesogastrium (gastric mesentery) and its architecture. We suggest for the first time a “Table model” to describe the relationship between the stomach and gastric mesenteries enveloped by fascia propria, which might provide an improvement in the surgical methods for excision of gastric cancer.