摘要
胃癌手术中胃短血管因解剖复杂、毗邻脾门及胰尾,其处理是手术难点,易致术中出血及术后并发症。远端胃切除术仅需处理脾下极约2根胃短血管,其长度较长、操作空间大,仅需具备一定的操作技巧即可实现安全有效的淋巴结清扫和血管结扎。而近端胃切除术和全胃切除术因脾上极胃短血管短、操作空间小,传统自下而上路径易发生出血且止血困难。采用“胃短先行”的处理策略能够解决传统策略下因视野遮挡及胃短血管过度牵拉引起的脾门出血问题,在确保淋巴结清扫质量的前提下提高手术的安全性。
During gastrectomy for gastric cancer,the short gastric vessels are a challenge in radical resection due to their complex anatomy and proximity to the splenic hilum and pancreatic tail,which can easily lead to intraoperative bleeding and postoperative complications.In distal gastrectomy,only 2 short gastric vessels at the inferior pole of the spleen need to be managed.These vessels are relatively long with a large operative space,and safe and effective lymph node dissection and vascular ligation can be achieved with minimal surgical skills.However,in proximal gastrectomy or total gastrectomy,the short gastric vessels at the superior pole of the spleen are short with a narrow operative space.The traditional bottom-up approach is prone to bleeding,and hemostasis is difficult in such cases.Adopting a“short gastric vessels first”strategy can address splenic hilum bleeding caused by visual field obstruction and excessive traction on the short gastric vessels under the traditional approach.This strategy improves surgical safety while ensuring the quality of lymph node dissection.
作者
王权
国瑀辰
依力哈尔·艾则孜
穆剑锋
WANG Quan;GUO Yu-chen;Yilihaer Aizezi;MU Jian-feng(Department of Gastrocolorectal Surgery,General Surgery Center,First Hospital of Jilin University,Changchun 130021,China)
出处
《中国实用外科杂志》
北大核心
2025年第7期763-765,共3页
Chinese Journal of Practical Surgery
基金
中国初级卫生保健基金会项目(No.ZLHZLCSH-2023-001)。
关键词
胃短血管
远端胃切除术
近端胃切除术
全胃切除术
出血
short gastric vessels
distal gastrectomy
proximal gastrectomy
total gastrectomy
hemorrhage
