{"title":"腹周筋膜间隙的解剖研究及腹腔镜入路的指导。","authors":"Guoliang Jin, Shuquan Duan, Ana Guan, Zhepeng Wang, Ranhao Zhang, Wenjuan Qiao, Qiuhong Wang, Liansheng Zheng","doi":"10.3389/fsurg.2024.1322079","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To study the anatomic characteristics of gastric peritoneum fascia space and provide a safe surgical approach for laparoscopic radical gastrectomy.</p><p><strong>Method: </strong>The morphological characteristics of perigastric fascia and fascial space and the course of important blood vessels were observed and studied in 2 fresh adult cadavers, 5 formalin immersed cadavers and 56 patients undergoing total gastrectomy. The hemoglobin, albumin, prealbumin, total protein, operation time, intraoperative blood loss, number of lymph node dissection and the incidence of complications before and after laparoscopic total gastrectomy with different approaches were statistically analyzed.</p><p><strong>Results: </strong>Through dissecting the cadaver, it is found that the space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery. The space between the prepancreatic fascia and the posterior gastric fascia is located in a plane, and the posterior gastric fascial space is connected with the gastrosplenic space and hepatogastric space. Through three different plane approaches, all can enter the space without blood vessels and nerves, so as to achieve complete gastrectomy. Statistical analysis of patients undergoing total gastrectomy with different approaches showed that there was no significant difference in operation time, intraoperative blood loss, number of lymph node dissection and postoperative complications among the three approaches (<i>P</i> > 0.05). There was no significant difference in postoperative hemoglobin, albumin, prealbumin and total protein (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>The space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery<b>.</b>the application of the anatomical study of perigastric fascial space in laparoscopic radical resection of gastric cancer not only accords with the tumor-free principle of radical resection of tumor, improves the safety of operation, but also reduces the occurrence of complications such as bleeding and important organ injury.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1322079"},"PeriodicalIF":1.6000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614758/pdf/","citationCount":"0","resultStr":"{\"title\":\"Anatomical study of perigastric fascial space and guidance for laparoscopic approach.\",\"authors\":\"Guoliang Jin, Shuquan Duan, Ana Guan, Zhepeng Wang, Ranhao Zhang, Wenjuan Qiao, Qiuhong Wang, Liansheng Zheng\",\"doi\":\"10.3389/fsurg.2024.1322079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To study the anatomic characteristics of gastric peritoneum fascia space and provide a safe surgical approach for laparoscopic radical gastrectomy.</p><p><strong>Method: </strong>The morphological characteristics of perigastric fascia and fascial space and the course of important blood vessels were observed and studied in 2 fresh adult cadavers, 5 formalin immersed cadavers and 56 patients undergoing total gastrectomy. The hemoglobin, albumin, prealbumin, total protein, operation time, intraoperative blood loss, number of lymph node dissection and the incidence of complications before and after laparoscopic total gastrectomy with different approaches were statistically analyzed.</p><p><strong>Results: </strong>Through dissecting the cadaver, it is found that the space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery. The space between the prepancreatic fascia and the posterior gastric fascia is located in a plane, and the posterior gastric fascial space is connected with the gastrosplenic space and hepatogastric space. Through three different plane approaches, all can enter the space without blood vessels and nerves, so as to achieve complete gastrectomy. Statistical analysis of patients undergoing total gastrectomy with different approaches showed that there was no significant difference in operation time, intraoperative blood loss, number of lymph node dissection and postoperative complications among the three approaches (<i>P</i> > 0.05). There was no significant difference in postoperative hemoglobin, albumin, prealbumin and total protein (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>The space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery<b>.</b>the application of the anatomical study of perigastric fascial space in laparoscopic radical resection of gastric cancer not only accords with the tumor-free principle of radical resection of tumor, improves the safety of operation, but also reduces the occurrence of complications such as bleeding and important organ injury.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"11 \",\"pages\":\"1322079\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614758/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2024.1322079\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2024.1322079","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Anatomical study of perigastric fascial space and guidance for laparoscopic approach.
Objective: To study the anatomic characteristics of gastric peritoneum fascia space and provide a safe surgical approach for laparoscopic radical gastrectomy.
Method: The morphological characteristics of perigastric fascia and fascial space and the course of important blood vessels were observed and studied in 2 fresh adult cadavers, 5 formalin immersed cadavers and 56 patients undergoing total gastrectomy. The hemoglobin, albumin, prealbumin, total protein, operation time, intraoperative blood loss, number of lymph node dissection and the incidence of complications before and after laparoscopic total gastrectomy with different approaches were statistically analyzed.
Results: Through dissecting the cadaver, it is found that the space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery. The space between the prepancreatic fascia and the posterior gastric fascia is located in a plane, and the posterior gastric fascial space is connected with the gastrosplenic space and hepatogastric space. Through three different plane approaches, all can enter the space without blood vessels and nerves, so as to achieve complete gastrectomy. Statistical analysis of patients undergoing total gastrectomy with different approaches showed that there was no significant difference in operation time, intraoperative blood loss, number of lymph node dissection and postoperative complications among the three approaches (P > 0.05). There was no significant difference in postoperative hemoglobin, albumin, prealbumin and total protein (P > 0.05).
Conclusions: The space of the posterior gastric fascia space is suitable for laparotomy and laparoscopic surgery.the application of the anatomical study of perigastric fascial space in laparoscopic radical resection of gastric cancer not only accords with the tumor-free principle of radical resection of tumor, improves the safety of operation, but also reduces the occurrence of complications such as bleeding and important organ injury.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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