文章摘要
沈 健,张建平.胃肠膜解剖的历史、现状及未来展望[J].南京医科大学学报,2020,(1):1~3
胃肠膜解剖的历史、现状及未来展望
The history,present situation and future prospect of gastrointestinal membrane anatomy
投稿时间:2019-12-17  
DOI:10.7655/NYDXBNS20200101
中文关键词: 膜解剖  胃癌  肠癌
英文关键词: membrane anatomy  gastric cancer  colorectal cancer
基金项目:国家自然科学基金(81874058);江苏省十三五强卫工程“青苗人才”(QNRC2016673)
作者单位
沈 健 南京医科大学第二附属医院普通外科江苏 南京 210029 
张建平 南京医科大学第二附属医院普通外科江苏 南京 210029 
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中文摘要:
      根治性切除+D2或D3淋巴结清扫术是胃肠道肿瘤的标准术式,但在结直肠癌手术中,全直肠系膜切除术(total mesorectal excision,TME)和完整结肠系膜切除术(complete mesocolic excision,CME)的出现,逐渐取代了淋巴结清扫术的主导地位,胃肠肿瘤的手术治疗开始进入“膜解剖”时代。膜解剖是在临床实践经年积累、临床基础研究和医学工业科技不断进步的前提下孕育而生的外科学新理念,以及在此理念指导下形成的规范化新手术范式。尽管膜解剖理论被越来越多的临床医生所接受,但仍然存在认识上的模糊和混淆。膜解剖怎样凝练成为系统理论并如何指导手术实践,是现代实用膜解剖研究中需要特别关注和亟待解决的问题。文章旨在通过系统回顾膜解剖理论的缘起与演进,简化膜解剖认识中的有关概念,帮助胃肠外科医生更好地理解膜解剖的基本理论及原理,并指导临床实践。目前膜解剖理论体系尚不完善,也期望有更多的学者能参与膜解剖,特别是胃癌膜解剖基础研究与临床探索中来,对“膜解剖”理论体系不断充实和完善,推动膜解剖的发展。
英文摘要:
      Radical resection+D2 or D3 lymphadenectomy is the standard operation for gastrointestinal tumor surgery. The appearance of total mesorectal excision(TME)and complete mesocolic excision(CME)gradually replaced the dominant position of lymphadenectomy in the colorectal cancer surgery,and the surgical treatment of gastrointestinal tumor began to enter the era of “membrane anatomy”. Membrane anatomy is a new concept of surgery and a standardized new operation paradigm under the guidance of the new concept,which is conceived by many factors such as the accumulation of clinical practice,the continuous progress of clinical basic research and medical industry science and technology. However,most clinicians lack in?depth understanding of the origin and current situation of membrane anatomy,the nature and technical composition of membrane anatomy are not very clear,and there are many complex and even wrong interpretations. More and more surgeons engaged in the research and exploration of membrane anatomy. How to condense the membrane anatomy into a systematic theory and guide the operation practice is a problem that needs special attention in the research of modern practical membrane anatomy. The purpose of this essay is to review the origin and evolution of membrane anatomy theory,define the concept of “membrane anatomy”,and help gastrointestinal surgeons to understand the basic theory and principle of membrane anatomy better. At present,the theoretical system of membrane anatomy is not perfect,and more scholars are expected to participate in the basic research or clinical exploration of membrane anatomy,especially for gastric cancer. The theoretical system of “membrane anatomy” is constantly enriched and improved to promote the development of membrane anatomy.
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