Research progress of membrane anatomy theory in laparoscopic surgery for middle-low rectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Zhe ^1,2,3 , ZHU Mingqian ^1,2,3 ,  XIONG Binghong ^1,2,3

1. NO.1 School of Clinical Medicine, Kunming Medical University, Kunming 650032, P. R. China;
2. Department of General Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;
3. Yunnan General Surgical Disease Clinical Medical Center, Kunming 650032, P. R. China;

Corresponding author：

XIONG Binghong, Email: xbh791220@163.com

Keywords：

membrane anatomy; rectal cancer; total mesorectal excision; fascia; space

DOI：

10.7507/1007-9424.202307031

Video：

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Objective To investigate the progress and controversy of membrane anatomy theory in laparoscopic surgery for mid-low rectal cancer. Method The literature related to membrane anatomy theory in recent years was reviewed and summarized. Results The membrane anatomy theory not only improved the effect of total mesorectal excision, ensured the integrity of the mesorectum, more standardized the operation and principles of rectal cancer surgery, but also provided the operator with a broad vision and clear anatomical hierarchy. The theory of membrane anatomy had important clinical significance for tumor radical resection, organ resection and functional protection. However, this theory had not been unified, and the establishment of membrane plane and the choice of surgical plane were still needed to be studied and explored. Conclusion At present, scholars at home still regard the theory of membrane anatomy as the theoretical support and reference basis for the endoscopic treatment of mid-low rectal cancer, which can provide surgeons with new treatment prospects and research direction, and improve the survival expectancy and quality of life of patients with intestinal cancer in the future.

Citation： ZHANG Zhe, ZHU Mingqian, XIONG Binghong. Research progress of membrane anatomy theory in laparoscopic surgery for middle-low rectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(11): 1384-1388. doi: 10.7507/1007-9424.202307031 Copy

1.	Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
2.	Siani LM, Lucchi A, Berti P, et al. Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: safety, prognostic factors and oncologic outcome. Am J Surg, 2017, 214(2): 222-227.
3.	池畔. 机器人全直肠系膜切除技巧与要领. 中国实用外科杂志, 2016, 36(11): 1148-1151.
4.	Kluth D, Jaeschke-Melli S, Fiegel H. The embryology of gut rotation. Semin Pediatr Surg, 2003, 12(4): 275-279.
5.	高志冬, 叶颖江. 完整结肠系膜切除术的相关解剖标志—系膜、筋膜和间隙. 中华胃肠外科杂志, 2016, 19(10): 1084-1087.
6.	Shinohara H, Kurahashi Y, Kanaya S, et al. Topographic anatomy and laparoscopic technique for dissection of No.6 infrapyloric lymph nodes in gastric cancer surgery. Gastric Cancer, 2013, 16(4): 615-620.
7.	Coffey JC. Surgical anatomy and anatomic surgery - clinical and scientific mutualism. Surgeon, 2013, 11(4): 177-182.
8.	高桥孝. 大肠癌根治术. 北京: 人民卫生出版社, 2003: 1-307.
9.	篠原尚, 水野惠文, 牧野尚彦. イラストレイテッド外科手術: 膜の解剖からみた術式のポイント. 日本: 医学書院, 2010: 1-482.
10.	Mike M, Kano N. Laparoscopic surgery for colon cancer: a review of the fascial composition of the abdominal cavity. Surg Today, 2015, 45(2): 129-139.
11.	Coffey J, Lavery I, Sehgal R. Mesenteric principles of gastrointestinal surgery: basic and applied science. UK: CRC Press, 2017: 57-68.
12.	龚建平. 外科膜解剖—新的外科学基础? 中华实验外科杂志, 2015, 32(2): 225-226.
13.	池畔, 王枭杰. 膜解剖—推动精准腔镜与机器人结直肠外科的动力. 中华胃肠外科杂志, 2019, 22(5): 406-412.
14.	龚建平. 膜解剖的兴起与混淆. 中华胃肠外科杂志, 2019, 22(5): 401-405.
15.	卫洪波, 方佳峰. 腹腔镜低位直肠癌手术精准筋膜解剖的原则与意义. 中华普外科手术学杂志 (电子版), 2022, 16(1): 13-17.
16.	林谋斌, 刘海龙, 江慧洪, 等. 结直肠手术膜解剖理论体系的探索. 中华胃肠外科杂志, 2021, 24(7): 575-581.
17.	孙凌宇, 杨冬冬, 郑宏群. 各种膜解剖理论—互斥还是包容. 中华胃肠外科杂志, 2020, 23(7): 643-647.
18.	龚建平. 右半结肠癌根治术的外科膜解剖. 中华结直肠疾病电子杂志, 2015, 4(6): 600-601.
19.	闫治波, 戴勇. 膜解剖在直肠癌手术中的应用. 临床外科杂志, 2021, 29(5): 415-417.
20.	韩方海, 钟广宇. 直肠癌全直肠系膜切除手术中保护盆腔自主神经的技术路径. 临床外科杂志, 2020, 28(5): 412-415.
21.	黄颖, 池畔. 膜解剖引导下的腹腔镜直肠手术. 中华腔镜外科杂志 (电子版), 2017, 10(6): 339-342.
22.	George D, Pramil K, Kamalesh NP, et al. Sexual and urinary dysfunction following laparoscopic total mesorectal excision in male patients: a prospective study. J Minim Access Surg, 2018, 14(2): 111-117.
23.	池畔. 基于膜解剖的腹腔镜与机器人结直肠肿瘤手术学. 北京: 人民卫生出版社, 2019: 3-4.
24.	魏波, 黄盛鑫, 古翔鹏, 等. 盆筋膜解剖及其与直肠固有筋膜关系研究. 中国实用外科杂志, 2021, 41(7): 768-773.
25.	Heald RJ. The ‘Holy Plane’ of rectal surgery. J R Soc Med, 1988, 81(9): 503-508.
26.	Stelzner S, Heinze T, Nikolouzakis TK, et al. Perirectal fascial anatomy: new insights into an old problem. Dis Colon Rectum, 2021, 64(1): 91-102.
27.	Kinugasa Y, Murakami G, Suzuki D, et al. Histological identification of fascial structures posterolateral to the rectum. Br J Surg, 2007, 94(5): 620-626.
28.	刘海龙, 常毅, 林谋斌. 科学解读膜解剖理论规范应用膜解剖名词. 中华胃肠外科杂志, 2020, 23(7): 634-642.
29.	Zhu XM, Yu GY, Zheng NX, et al. Review of Denonvilliers’ fascia: the controversies and consensuses. Gastroenterol Rep (Oxf), 2020, 8(5): 343-348.
30.	黄江龙, 方佳峰, 郑宗珩, 等. 首次发现: Denonvilliers筋膜手术标识线的术中辨识. 中国实用外科杂志, 2018, 38(11): 1236-1240.
31.	张辉亮, 庄競. 腹腔镜结直肠外科膜解剖的再认识. 临床外科杂志, 2018, 26(10): 731-732.
32.	卫洪波, 方佳峰. 基于膜解剖理念的保留邓氏筋膜全直肠系膜切除术. 中华胃肠外科杂志, 2020, 23(7): 666-669.
33.	Wei B, Zheng Z, Fang J, et al. Effect of Denonvilliers’ fascia preservation versus resection during laparoscopic total mesorectal excision on postoperative urogenital function of male rectal cancer patients: initial results of Chinese PUF-01 randomized clinical trial. Ann Surg, 2021, 274(6): e473-e480.
34.	Fang J, Huang J, Zheng Z, et al. How to find Denonvilliers’ fascia during laparoscopic TME. Tech Coloproctol, 2019, 23(4): 391-392.
35.	张卫, 朱晓明. 基于盆腔膜解剖的腹腔镜全直肠系膜切除术. 中华胃肠外科杂志, 2019, 22(5): 427-431.
36.	Huang J, Liu J, Fang J, et al. Identification of the surgical indication line for the Denonvilliers’ fascia and its anatomy in patients with rectal cancer. Cancer Commun (Lond), 2020, 40(1): 25-31.
37.	Fang J, Zheng Z, Wei H. Reconsideration of the anterior surgical plane of total mesorectal excision for rectal cancer. Dis Colon Rectum, 2019, 62(5): 639-641.
38.	谢礼锋, 李新宇. TME的膜解剖学基础及自主神经损伤机制的认识与保护. 结直肠肛门外科, 2023, 29(1): 6-13.
39.	Coffey JC, O'Leary DP. The mesentery: structure, function, and role in disease. Lancet Gastroenterol Hepatol, 2016, 1(3): 238-247.
40.	龚建平. 再论膜解剖的兴起与混淆. 中华胃肠外科杂志, 2020, 23(7): 629-633.

1. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg, 1982, 69(10): 613-616.
2. Siani LM, Lucchi A, Berti P, et al. Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: safety, prognostic factors and oncologic outcome. Am J Surg, 2017, 214(2): 222-227.
3. 池畔. 机器人全直肠系膜切除技巧与要领. 中国实用外科杂志, 2016, 36(11): 1148-1151.
4. Kluth D, Jaeschke-Melli S, Fiegel H. The embryology of gut rotation. Semin Pediatr Surg, 2003, 12(4): 275-279.
5. 高志冬, 叶颖江. 完整结肠系膜切除术的相关解剖标志—系膜、筋膜和间隙. 中华胃肠外科杂志, 2016, 19(10): 1084-1087.
6. Shinohara H, Kurahashi Y, Kanaya S, et al. Topographic anatomy and laparoscopic technique for dissection of No.6 infrapyloric lymph nodes in gastric cancer surgery. Gastric Cancer, 2013, 16(4): 615-620.
7. Coffey JC. Surgical anatomy and anatomic surgery - clinical and scientific mutualism. Surgeon, 2013, 11(4): 177-182.
8. 高桥孝. 大肠癌根治术. 北京: 人民卫生出版社, 2003: 1-307.
9. 篠原尚, 水野惠文, 牧野尚彦. イラストレイテッド外科手術: 膜の解剖からみた術式のポイント. 日本: 医学書院, 2010: 1-482.
10. Mike M, Kano N. Laparoscopic surgery for colon cancer: a review of the fascial composition of the abdominal cavity. Surg Today, 2015, 45(2): 129-139.
11. Coffey J, Lavery I, Sehgal R. Mesenteric principles of gastrointestinal surgery: basic and applied science. UK: CRC Press, 2017: 57-68.
12. 龚建平. 外科膜解剖—新的外科学基础? 中华实验外科杂志, 2015, 32(2): 225-226.
13. 池畔, 王枭杰. 膜解剖—推动精准腔镜与机器人结直肠外科的动力. 中华胃肠外科杂志, 2019, 22(5): 406-412.
14. 龚建平. 膜解剖的兴起与混淆. 中华胃肠外科杂志, 2019, 22(5): 401-405.
15. 卫洪波, 方佳峰. 腹腔镜低位直肠癌手术精准筋膜解剖的原则与意义. 中华普外科手术学杂志 (电子版), 2022, 16(1): 13-17.
16. 林谋斌, 刘海龙, 江慧洪, 等. 结直肠手术膜解剖理论体系的探索. 中华胃肠外科杂志, 2021, 24(7): 575-581.
17. 孙凌宇, 杨冬冬, 郑宏群. 各种膜解剖理论—互斥还是包容. 中华胃肠外科杂志, 2020, 23(7): 643-647.
18. 龚建平. 右半结肠癌根治术的外科膜解剖. 中华结直肠疾病电子杂志, 2015, 4(6): 600-601.
19. 闫治波, 戴勇. 膜解剖在直肠癌手术中的应用. 临床外科杂志, 2021, 29(5): 415-417.
20. 韩方海, 钟广宇. 直肠癌全直肠系膜切除手术中保护盆腔自主神经的技术路径. 临床外科杂志, 2020, 28(5): 412-415.
21. 黄颖, 池畔. 膜解剖引导下的腹腔镜直肠手术. 中华腔镜外科杂志 (电子版), 2017, 10(6): 339-342.
22. George D, Pramil K, Kamalesh NP, et al. Sexual and urinary dysfunction following laparoscopic total mesorectal excision in male patients: a prospective study. J Minim Access Surg, 2018, 14(2): 111-117.
23. 池畔. 基于膜解剖的腹腔镜与机器人结直肠肿瘤手术学. 北京: 人民卫生出版社, 2019: 3-4.
24. 魏波, 黄盛鑫, 古翔鹏, 等. 盆筋膜解剖及其与直肠固有筋膜关系研究. 中国实用外科杂志, 2021, 41(7): 768-773.
25. Heald RJ. The ‘Holy Plane’ of rectal surgery. J R Soc Med, 1988, 81(9): 503-508.
26. Stelzner S, Heinze T, Nikolouzakis TK, et al. Perirectal fascial anatomy: new insights into an old problem. Dis Colon Rectum, 2021, 64(1): 91-102.
27. Kinugasa Y, Murakami G, Suzuki D, et al. Histological identification of fascial structures posterolateral to the rectum. Br J Surg, 2007, 94(5): 620-626.
28. 刘海龙, 常毅, 林谋斌. 科学解读膜解剖理论规范应用膜解剖名词. 中华胃肠外科杂志, 2020, 23(7): 634-642.
29. Zhu XM, Yu GY, Zheng NX, et al. Review of Denonvilliers’ fascia: the controversies and consensuses. Gastroenterol Rep (Oxf), 2020, 8(5): 343-348.
30. 黄江龙, 方佳峰, 郑宗珩, 等. 首次发现: Denonvilliers筋膜手术标识线的术中辨识. 中国实用外科杂志, 2018, 38(11): 1236-1240.
31. 张辉亮, 庄競. 腹腔镜结直肠外科膜解剖的再认识. 临床外科杂志, 2018, 26(10): 731-732.
32. 卫洪波, 方佳峰. 基于膜解剖理念的保留邓氏筋膜全直肠系膜切除术. 中华胃肠外科杂志, 2020, 23(7): 666-669.
33. Wei B, Zheng Z, Fang J, et al. Effect of Denonvilliers’ fascia preservation versus resection during laparoscopic total mesorectal excision on postoperative urogenital function of male rectal cancer patients: initial results of Chinese PUF-01 randomized clinical trial. Ann Surg, 2021, 274(6): e473-e480.
34. Fang J, Huang J, Zheng Z, et al. How to find Denonvilliers’ fascia during laparoscopic TME. Tech Coloproctol, 2019, 23(4): 391-392.
35. 张卫, 朱晓明. 基于盆腔膜解剖的腹腔镜全直肠系膜切除术. 中华胃肠外科杂志, 2019, 22(5): 427-431.
36. Huang J, Liu J, Fang J, et al. Identification of the surgical indication line for the Denonvilliers’ fascia and its anatomy in patients with rectal cancer. Cancer Commun (Lond), 2020, 40(1): 25-31.
37. Fang J, Zheng Z, Wei H. Reconsideration of the anterior surgical plane of total mesorectal excision for rectal cancer. Dis Colon Rectum, 2019, 62(5): 639-641.
38. 谢礼锋, 李新宇. TME的膜解剖学基础及自主神经损伤机制的认识与保护. 结直肠肛门外科, 2023, 29(1): 6-13.
39. Coffey JC, O'Leary DP. The mesentery: structure, function, and role in disease. Lancet Gastroenterol Hepatol, 2016, 1(3): 238-247.
40. 龚建平. 再论膜解剖的兴起与混淆. 中华胃肠外科杂志, 2020, 23(7): 629-633.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research progress of membrane anatomy theory in laparoscopic surgery for middle-low rectal cancer

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