Zhang C X, Tan H, Ding J M, Xu H, Sun F
First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China Department of Proctology, Yubei Hospital of Traditional Chinese Medicine, Chongqing Yubei District, Chongqing 401120, China.
First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Jul 25;26(7):650-655. doi: 10.3760/cma.j.cn441530-20230323-00091.
The theory of membrane anatomy has been widely used in the field of colorectal surgery. The key point to perform high quality total mesorectal excision (TME) and complete mesocolic excision (CME) is to identify the correct anatomical plane. Intraoperative identification of the various fasciae and fascial spaces is the key to accessing the correct surgical plane and surgical success. The landmark vessels refer to the small vessels that originate from the original peritoneum on the surface of the abdominal viscera during embryonic development and are produced by the fusion of the fascial space. From the point of view of embryonic development, the abdominopelvic fascial structure is a continuous unit, and the landmark vessels on its surface do not change morphologically with the fusion of fasciae and have a specific pattern. Drawing on previous literature and clinical surgical observations, we believe that tiny vessels could be used to identify various fused fasciae and anatomical planes. This is a specific example of membrane anatomical surgery.
膜解剖学理论已在结直肠外科领域广泛应用。实施高质量全直肠系膜切除术（TME）和完整结肠系膜切除术（CME）的关键在于识别正确的解剖平面。术中识别各种筋膜和筋膜间隙是进入正确手术平面并取得手术成功的关键。标志性血管是指胚胎发育过程中起源于腹腔脏器表面原始腹膜的小血管，由筋膜间隙融合产生。从胚胎发育角度看，腹盆腔筋膜结构是一个连续的单元，其表面的标志性血管不会随筋膜融合而发生形态改变，且具有特定的走行规律。借鉴既往文献及临床手术观察，我们认为微小血管可用于识别各种融合筋膜及解剖平面。这是膜解剖学手术的一个具体实例。
