膜解剖理论指导下的结肠癌根治术

Radical surgery for colon cancer guided by membrane anatomy theory

与其他实体肿瘤一样,结肠癌也经历了从瘤体切除到器官切除、再到淋巴结清扫的百年历程。从Toldt间隙到完整系膜切除,从局部切除到D_(3)根治术,局部复发率虽然得到了降低,但仍然困扰着医生和患者。基于膜解剖的理论,结肠癌根治术将更加注重在将系膜从系膜床剥离的同时,保持系膜后筋膜的完整性,以尽可能避免"第五转移"继发癌泄露的发生。得益于膜解剖理论的提出及其广泛稳定的可重复性和可复制性,结直肠外科手术将走向新的阶段。

Like other solid tumors,colon cancer surgery has undergone a century-old journey from lumpectomy to organ resection and then to lymphadenectomy.From the Toldt fascia to complete mesenteric resection,and from local resection to D_(3) radical treatment,local recurrence rates have been reduced,but remain a nuisance to surgeons and patients.Based on the theory of membrane anatomy,radical surgery for colon cancer will focus more on removing the mesocolon from the mesentery bed while maintaining the integrity of the posterior fascia to avoid the occurrence of"fifth metastasis"as much as possible.Thanks to the membrane anatomy theory,its strong reproducibility and replicability,a new phase of colorectal surgery is on the horizon.