[Replication of 3D laparoscopic membrane anatomic radical gastrectomy for gastric cancer].

According to the current evidence-based medicine researches, the eastern and western countries have reached a consensus that D2 operation is a standardized procedure for advanced gastric cancer.However, the postoperative five-year survival rate is still not satisfactory. Professor Gong Jianping of Tongji Hospital, Tongji Medical Gollege of Huazhong University of Science and Technology proposed a theory of membrane anatomy (the third element of surgical anatomy) and the concept of cancer leakage-an epoch-making concept in surgical anatomy. The Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University was honored to be selected as one of the first domestic replication units of 3D laparoscopic radical gastrectomy under membrane anatomy. Professor Gong Jianping has visited our hospital several times for surgical demonstration, explanation of membrane anatomy theory and replication training. Through the understanding of membrane anatomy theory, we found that 3D laparoscopic radical gastrectomy guided by membrane anatomy can achieve good results, e.g less bleeding, complete resection, complete lymph node dissection and avoidance of side damage, meanwhile the operation is simple and safe. At the same time, it can avoid the shedding of cancer cells, so as to reduce the iatrogenic leakage of cancer and improve the efficacy of radical gastrectomy. In addition, the standardized procedure of laparoscopic radical gastrectomy makes it scientific, reproducible and easy to be popularized.根据目前循证医学研究，对于进展期胃癌D2手术作为规范化标准手术，东西方国家已经达成共识。但术后5年患者的生存率仍不尽如人意。华中科技大学同济医学院附属同济医院龚建平教授提出膜解剖的理论（外科解剖的第三元素）及癌泄漏概念，是外科解剖学上一个划时代的概念。贵州医科大学附属医院胃肠外科作为国内首批膜解剖下3D腹腔镜胃癌根治术的复制单位，通过龚建平教授多次到院进行的手术演示和膜解剖理论讲解以及进行的复制培训，使我们对膜解剖理论有了深入理解，同时在手术实践中我们发现，在膜解剖引导下的3D腹腔镜胃癌根治术，能达到出血少、完整切除、淋巴清扫彻底和避免副损伤的效果；手术操作简易安全；可避免癌细胞脱落，从而减少医源性癌泄露；能达到提高胃癌根治手术疗效的作用。另外，也使得腹腔镜胃癌根治术操作程序化和标准化，具备科学性及可复制性，易于推广。.