Disassociation and anatomical observation of gastroepiploic left mesentery via transverse colon approach in laparoscopic radical gastrectomy under the guidance of membrane anatomy theory
Disassociation and anatomical observation of gastroepiploic left mesentery via transverse colon approach in laparoscopic radical gastrectomy under the guidance of membrane anatomy theory
Objective:To observe the anatomical characteristics of the left gastroepiploic mesentery in laparoscopic radical gas-trectomy for gastric cancer under the guidance of the membranous anatomy theory,and to explore the value of the left gastroepiploic mes-entery dissociation through the transverse colon approach.Methods:The clinical data of 42 patients who underwent laparoscopic radical gastrectomy under the guidance of membrane anatomy theory from Jan.2022 to Feb.2024 were retrospectively analyzed.The time of left gastroepiploic mesentery dissociation,intraoperative blood loss,the number of cleared lymph nodes,postoperative related complications,and postoperative recovery were recorded.Results:All 42 operations were successful.The surface of the left gastroepiploic mesentery was encapsulated by intact membranous tissue,with the root of the mesentery at the origin of the left gastroepiploic vessel,and the body of the mesentery lying upside down on the bed of the mesentery consisting of the colonic splenic flexure and the mesentery,the anterior renal fascia of the lower pole of the spleen,and the fascia propria of the pancreas at the caudal portion of the pancreas,which showed multifarious three-dimensional structures.The time of left gastroepiploic mesentery dissection was 20～33 min,with an average of(24±3.2)min,the amount of bleeding was 2～15 mL,with an average of(6.5±1.3)mL,and the number of lymph nodes dissected was 4～8,with an average of(5.6±2.1).Postoperative anastomotic stenosis,anastomotic bleeding,reflux esophagitis,incision infection and pulmonary infection occurred in 1 case respectively,all were cured by conservative treatment,and there was no surgical death.Conclu-sions:The left gastroepiploic mesentery could be observed in laparoscopic radical gastrectomy for gastric cancer under the guidance of membranous anatomy theory.The strategy of left gastroepiploic mesentery dissociation via transverse colon approach is feasible and reproducible,and has application value.
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