Xie D X, Shen J, Meng W J, Gong J P
Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Jul 25;26(7):707-712. doi: 10.3760/cma.j.cn441530-20230419-00127.
In the past decade, the concept of membrane anatomy has been gradually applied in gastric cancer surgery. Based on this theory, D2 lymphadenectomy plus complete mesogastric excision (D2+CME) has been proposed, which has been demonstrated to significantly reduce intraoperative bleeding and intraperitoneal free cancer cells during surgery, decrease surgical complications, and improve survival. These results indicate that membrane anatomy is feasible and efficacious in gastric cancer surgery. In this review, we will describe the important contents of membrane anatomy, including "Metastasis V"(2013, 2015), proximal segmentation of dorsal mesogastrium (2015), D2+CME procedure (2016), "cancer leak"(2018), and surgical outcomes of D2+CME (2022).
在过去十年中,膜解剖学概念已逐渐应用于胃癌手术。基于这一理论,有人提出了D2淋巴结清扫术加完整的胃系膜切除术(D2+CME),事实证明,该手术能显著减少术中出血和手术过程中腹腔内游离癌细胞,降低手术并发症,并提高生存率。这些结果表明,膜解剖学在胃癌手术中是可行且有效的。在这篇综述中,我们将描述膜解剖学的重要内容,包括“转移V”(2013年、2015年)、胃背系膜近端分割(2015年)、D2+CME手术(2016年)、“癌性渗漏”(2018年)以及D2+CME的手术结果(2022年)。