摘要
目的:胃结肠共同干是胃肠道手术的重要解剖标志，在胃结肠共同干及其属支表面偶尔会出现小的静脉属支，本研究拟对小静脉属支在胃结肠共同干及其属支表面出现的概率进行统计。方法:收集于2017年1月至2022年10月行右半结肠癌根治术患者资料37例，通过回顾手术视频对胃结肠共同干及其属支表面出现的小静脉进行记录和统计。结果:在存在胃结肠共同干的31例患者中，7例患者存在较粗属支(Ⅰ型)，均位于胃结肠共同干主干，出现概率为22.6%。3例患者胃结肠共同干表面存在较细属支(Ⅱ型)，1例患者胃网膜右静脉表面存在Ⅱ型属支。此外，有1例患者在胃网膜右静脉和副右结肠静脉表面同时存在Ⅱ型属支。在没有胃结肠共同干的6例患者中，1例患者在胃网膜右静脉表面存在Ⅰ型属支，另1例患者胃网膜右静脉表面存在Ⅱ型属支。结论:Ⅰ型属支主要分布于胃结肠共同干表面，容易发现，不易损伤。而Ⅱ型属支在胃结肠共同干及其属支表面均可出现，Ⅱ型属支相对纤细，术中不易辨认，容易损伤导致出血。
Abstract
Objective:Gastrocolic trunk of Henle (GCT) is considered as an important anatomical landmark in the gastrointestinal surgery. Small venous tributaries of GCT and its tributaries can be occasionally observed. In this study, we counted the probability of the appearance of small venous tributaries on the surface of GCT and its tributaries.Methods:Data of 37 patients who underwent radical surgery for right hemicolonic cancer from Jan. 2017 to Oct. 2022 were collected in this study. The videos of the 37 surgical procedures were collected. Small veins appearing on the surface of GCT and its tributaries were recorded and counted by reviewing the surgical videos.Results:Among the 31 patients with GCT, thicker tributaries (type Ⅰ) presented in 7 patients, all of which were located on the surface of GCT (22.6%). Thinner tributaries (type Ⅱ) presented on the surface of GCT in 3 patients, while on the surface of right gastroepiploic vein (RGEV) in 1 patient. In addition, there was 1 case with two type Ⅱ small tributaries on the surface of both RGEV and superior right colic vein (SRCV). Among the 6 patients without GCT, 1 patient had type Ⅰ tributaries on the surface of RGEV, while another patient had type Ⅱ tributaries located on the surface of RGEV.Conclusion:Type Ⅰ tributaries were mainly distributed on the surface of GCT which were easy to detect and not easily damaged. On the other hand, type Ⅱ tributaries can be found on the surface of both GCT and its tributaries. Type Ⅱ tributaries are relatively thinner, which makes it difficult to identify during operation, and prone to injury leading to bleeding.
基金项目
天津市自然科学基金项目(21JCYBJC01730)
天津医科大学第二医院青年基金项目(2019ydey02)
天津医科大学第二医院青年基金项目(2020ydey20)
万方数据