人体的功能层解剖模型及其在胃肠外科中应用的探讨

Proposal of the hypothetical model of functional layers and its application in the gastrointestinal surgery

目前的胃肠外科手术（甚至所有的外科手术）都是基于系统解剖学和局部解剖学的认识与思路。我们以胚胎学为借鉴和来源，在人体分层解剖结构的基础上．建立了人体功能层解剖模型。并从这一模型出发，提出了腹膜腔一系膜层、系膜外间隙和筋膜系统等新的解剖学概念，提出了对浆膜划分、系膜划分和肿瘤T分期划分的再认识，在胃肠外科领域进一步提出了功能层切除术的理念和相关阐释。这一模型的建立，也许将成为传统解剖模型的有益补允．为外科手术思维带来崭新启示，对它的研究和应用才刚刚开始，并且还有待论证。

The current practice of gastrointestinal surgery, or even any surgical procedure is based on knowledge and ideas of systematic or topographic anatomy. Herein, we establish a model of the human functional anatomical layer, based on the stratified anatomical structure and the interpretation of surgical embryology. New anatomical concepts, such as peritoneal cavity-mesenteric layer, extra- mesenteric space, and fascia system were deduced and proposed, also a renewed understanding of serous division, mesenteric division and the T staging of tumor was put forward. We also propose the concept of Functional Layer Resection （FLR） and made some related interpretation as in the field of gastrointestinal surgery. The establishment of this hypothetical model may be a useful complement to the traditional anatomical model, although the research has just begun to take shape and the application remains to be demonstrated, this novel model had shed light upon newconcept and new inspiration of surgical reflection.