本文關(guān)鍵詞： 腹腔鏡 腎前筋膜間平面 精準(zhǔn)解剖 層面外科 解剖標(biāo)志　出處：《中國臨床解剖學(xué)雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討腎前筋膜間平面無血腹腔鏡上尿路手術(shù)入路精準(zhǔn)解剖與技巧(Inter-prerenalfascia planes in urological laparoscopic operations,IpULO)。方法采用尸體解剖、320排CT影像解剖研究及臨床病例活體腹腔鏡手術(shù)研究,對IpULO手術(shù)中腎前筋膜間平面相關(guān)解剖標(biāo)志在腹腔鏡下的形態(tài)特點(diǎn)進(jìn)行觀察研究。結(jié)果腎前筋膜間平面是腎前間隙多層次的無血管筋膜結(jié)構(gòu),層面間充滿蜘蛛絲網(wǎng)格狀白色纖維組織,在IpULO手術(shù)過程中存在7個重要的外科平面:Told’t筋膜間平面、結(jié)腸融合筋膜腎前融合筋膜間平面、結(jié)腸融合筋膜胰十二指腸前融合筋膜間平面、胰十二指腸后融合筋膜腎前融合筋膜間平面、腎前融合筋膜腎筋膜前葉間平面、腎筋膜前葉腎脂肪囊外平面、腎前腎筋膜前葉下平面。結(jié)論IpULO手術(shù)是基于層面外科的精準(zhǔn)解剖入路,腎前筋膜間平面是IpULO手術(shù)的重要解剖層面,術(shù)中能推窗見景,避免解剖迷失。
[Abstract]:Objective to investigate the accurate anatomy and technique of interpreexisting fascia planes in urological laparoscopic operation IpULOA via laparoscopic upper urinary approach in the prerenal interfascial plane. Methods Anatomy of cadaveric dissection with 320 row CT image and clinical case with in vivo laparoscopic surgery were studied. The morphological characteristics of anatomic markers related to the prerenal interfascial plane in IpULO operation were observed and studied under laparoscopy. Results the prerenal interfascial plane was a multilevel vascularized fascia structure in the prerenal space. There are seven important surgical plane: Toldt interfascial plane and colonic fusion fascia prerenal interfascial plane during IpULO operation. Colonic fusion fascia anterior fusion fascia plane, posterior pancreaticoduodenal fusion fascia anterior fusion fascia plane, anterior renal fascia fusion fascia anterior interlobar plane, renal fascial anterior lobar renal fat capsule plane, colonic fusion fascia anterior fusion fascia interfascial plane, pancreaticoduodenal posterior fusion fascia anterior fusion fascia interfascial plane. Conclusion IpULO operation is a precise anatomical approach based on plane surgery, and the plane of prerenal fascia is an important anatomical layer of IpULO surgery. During the operation, the window can be pushed to avoid dissection loss.
【作者單位】： 貴州省貴陽市第二人民醫(yī)院泌尿外科;蘇州大學(xué)附屬第一醫(yī)院泌尿外科;中山大學(xué)附屬第三醫(yī)院泌尿外科;貴州醫(yī)科大學(xué)附屬醫(yī)院泌尿外科;貴州醫(yī)科大學(xué)附屬醫(yī)院小兒外科;
【基金】：貴州省衛(wèi)計(jì)委科學(xué)技術(shù)基金資助項(xiàng)目(黔衛(wèi)發(fā)[2013]71號gzwkj2013-1-021) 貴州省科技廳基金資助項(xiàng)目(黔科合J字[2012]2053號) 貴陽市社會發(fā)展與民生科技計(jì)劃基金資助項(xiàng)目(筑科合[20141001]66號)
【分類號】：R699;R322.6

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本文編號：1513821