膜层面导向下腹腔镜结直肠癌手术体会

Experience of laparoscopic colorectal cancer operation guided by membrane plane

外科手术中,如何进入正确的手术层面直接决定着一台手术的成败和观感。特别是对于结直肠癌的根治手术,错误的手术层面意味着出血、肿瘤残留以及并发症。那么究竟应该如何进入正确手术层面并维持层面拓展?近30年来微创外科的发展,使其进入了腹腔镜的时代,同时完整系膜切除理念的推出,使人们开始认识到手术解剖层面的重要性,从组织、神经、血管为导向寻找手术层面,逐渐发展为以膜层面为导向,沿着膜层面的规律去寻找手术层面,可以达到更完整意义上的微创。本文从结直肠的胚胎发育和膜的解剖特征两方面来介绍外科膜层面,指导腹腔镜结直肠手术。

In surgery,how to enter the correct field of operation directly determines the success or failure of an operation and perception.Especially for radical surgery for colorectal cancer,the wrong surgical field means bleeding,residual tumors and complications.So how to get into the right field and turn around in it?In recent 30 years,the development of minimally invasive surgery has brought it into the era of laparoscopy.At the same time,the introduction of the concept of complete mesangiectomy has made people begin to realize the importance of surgical anatomy.It is guided by tissue,nerve and blood vessel to find the operative level.It has gradually developed into a guided by membrane anatomy and searched along the rules of membrane anatomy.At the surgical level,minimally invasive surgery can be achieved in a more complete sense.This article introduces the anatomy of the surgical membrane from the embryonic development of the colorectal membrane and the anatomical characteristics of the membrane to guide laparoscopic colorectal surgery.