Universalization of the operative strategy by systematic mesogastric excision for stomach cancer with that for total mesorectal excision and complete mesocolic excision colorectal counterparts.
Universalization of the operative strategy by systematic mesogastric excision for stomach cancer with that for total mesorectal excision and complete mesocolic excision colorectal counterparts.
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DOI：
10.1002/ags3.12048
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发表时间：
2018-01
影响因子：
2.7
通讯作者：
Sasako M
中科院分区：
文献类型：
--
作者：
Shinohara H;Kurahashi Y;Haruta S;Ishida Y;Sasako M
胃肠道肿瘤手术的目的是通过切除器官特有的肠系膜来完整地切除原发肿瘤及其淋巴引流。这一概念在结直肠癌手术中被提倡为全直肠系膜切除术(TME)或完全系膜切除术(CME)，但由于胃肠系膜的形态复杂，这一概念并不直接适用于胃癌。本文通过对胃系膜的胚胎学的介绍，讨论了胃系膜的独特解剖特征，揭示了其与乙状结肠系膜的相似性，并提出了一种基于系膜的D2胃切除术的理论概念，即系统的中胃切除，它可以使胃癌的手术策略与TME和CME结直肠癌的手术策略通用化。
Gastrointestinal cancer surgery aims at en bloc removal of the primary tumor with its lymphatic drainage by excising organ‐specific mesentery as an “intact package”. This concept was advocated in colorectal cancer surgery as total mesorectal excision (TME) or complete mesocolic excision (CME) procedures, but is not directly applicable to stomach cancer as a result of the morphological complexities of the gastric mesentery. In this review, we discuss the unique anatomical features of the mesogastrium by introducing its embryology, disclose its similarity to the mesosigmoid, and then propose a theoretical concept to mesentery‐based D2 gastrectomy, namely systematic mesogastric excision, which can universalize the operative strategy of stomach cancer with that of TME and CME colorectal counterparts.
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