Brachini Gioia, Cirillo Bruno, Matteucci Matteo, Cirocchi Roberto, Tebala Giovanni Domenico, Cavaliere Davide, Giacobbi Lorenza, Papa Veronica, Solaini Leonardo, Avenia Stefano, D'Andrea Vito, Davies Justin, Fedeli Piergiorgio, De Santis Elena
Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy.
Department of Medicine and Surgery, University of Milan, 20122 Milan, Italy.
J Clin Med. 2023 Sep 27;12(19):6233. doi: 10.3390/jcm12196233.
Fredet's fascia represents a crucial landmark for vascular surgical anatomy, especially in minimally invasive complete mesocolic excision (CME) for right-sided colon adenocarcinoma. Fredet's fascia allows access to the gastrocolic trunk of Henle (GCTH), the most critical step in both open and minimally invasive right-sided CME techniques. Despite this, a recent workshop of expert surgeons on the standardization of the laparoscopic right hemicolectomy with CME did not recognize or include the term of Fredet's fascia or area. Hence, we undertook a systematic review of articles that include the terms "Fredet's fascia or area", or synonyms thereof, with special emphasis on the types of articles published, the nationality, and the relevance of this area to surgical treatments.
We conducted a systematic review up to 15 July 2022 on PubMed, WOS, SCOPUS, and Google Scholar.
The results of the study revealed that the term "Fredet's fascia" is poorly used in the English language medical literature. In addition, the study found controversial and conflicting data among authors regarding the definition of "Fredet's fascia" and its topographical limits.
Knowledge of Fredet's fascia's surgical relevance is essential for colorectal surgeons to avoid accidental injuries to the superior mesenteric vascular pedicle during minimally invasive right hemicolectomies with CME. In order to avoid confusion and clarify this fascia for future use, we suggest moving beyond the use of the eponymous term by using a "descriptive term" instead, based on the fascia's anatomic structure. Fredet's fascia could, therefore, be more appropriately renamed "sub-mesocolic pre-duodenopancreatic fascia".
弗雷代筋膜是血管外科解剖学的一个关键标志，尤其是在右侧结肠癌的微创全结肠系膜切除术（CME）中。弗雷代筋膜有助于显露亨利胃结肠干（GCTH），这是开放和微创右侧CME技术中最关键的步骤。尽管如此，最近一次关于腹腔镜右半结肠切除术与CME标准化的专家外科医生研讨会并未认可或提及弗雷代筋膜或其区域这一术语。因此，我们对包含“弗雷代筋膜或区域”及其同义词的文章进行了系统综述，特别关注所发表文章的类型、国籍以及该区域与手术治疗的相关性。
我们截至2022年7月15日在PubMed、WOS、SCOPUS和谷歌学术上进行了系统综述。
研究结果显示，“弗雷代筋膜”一词在英语医学文献中使用较少。此外，研究发现作者之间关于“弗雷代筋膜”的定义及其地形学界限存在有争议和相互矛盾的数据。
了解弗雷代筋膜的手术相关性对于结直肠外科医生在进行微创右侧CME右半结肠切除术时避免意外损伤肠系膜上血管蒂至关重要。为了避免混淆并明确该筋膜以供未来使用，我们建议摒弃使用该人名命名的术语，而是根据筋膜的解剖结构使用一个“描述性术语”。因此，弗雷代筋膜可以更恰当地重新命名为“结肠系膜下十二指肠胰前筋膜”。
