摘要
腹腔镜胃癌手术作为一种微创的手术方式，已逐步被外科医师所接受并在世界范围内得到推广。然而，由于腹腔镜手术过程中不能获取全面的视野而难以建立组织间的三维关系，如果对胃周围血管变异缺乏有效的认识，术中可能造成胃周围血管的损伤，引起大量的出血并影响手术视野，甚至可能使手术的根治程度受损。我们根据腹腔镜胃癌手术操作步骤，将胃周血管分为幽门下、胰腺上及脾门3个区域，并对以上区域的常见血管变异情况进行了分析总结。我们认为，遵循正确的解剖间隙、熟悉胃周围血管及对其常见变异进行技巧性处理，有助于安全有效地完成手术，提高淋巴结清扫水平及减少术中副损伤。
Laparoscopic gastric cancer surgery, which has been gradually accepted by surgeons and popularized worldwide, is a less invasive alternative compared with an open procedure. However, the lack of cognition of the variation in perigastric vessels, and the difficulty to obtain a full-view image and to estimate the three-dimensional （3D） relationships between organs during laparoscopic procedures may lead to unexpected injuries of these vessels, causing massive bleeding, which would prevent surgeon from having access to a good view of the operative field. We retrospectively summarize the data of laparoscopic gastric cancer operation inour hospital, separate the perigastric vessels into three areas according to the procedure, respectively the inferior pylorus, superior pancreas, and hilum of spleen, and analyze the common anatomical variation of vessels and its characters. We propose that, following the right anatomical spaces, the familiarity of perigastric vessels and skills of treating its common anatomical variations, may contribute to the safe and effective operation, improve the level of lymph node dissection, and reduce the injury in the operation.
出处
《中华胃肠外科杂志》
CAS
CSCD
2014年第8期756-759,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
腹腔镜
胃肿瘤
血管变异
Laparoscopy
Stomach neoplasm
Vessels variation
