[Basic research and clinical applications progress of gastrointestinal developmental anatomy surgery]

Area of Science:

• Surgical oncology
• Developmental anatomy
• Gastrointestinal surgery

Background:

• Current mesenteric surgeries like TME and CME rely on anatomical landmarks but lack theoretical guidance, hindering standardization.
• Dissection boundaries often depend on surgeon experience, creating a gap between clinical practice and theory.
• Promoting homogeneous surgical outcomes requires a more robust theoretical framework for gastrointestinal tumor treatment.

Purpose of the Study:

• To introduce the concept of gastrointestinal developmental anatomy surgery based on "reverse embryonic development."
• To establish a theoretical framework for improving the precision, safety, and reproducibility of radical gastrointestinal surgeries.
• To deconstruct adult anatomy by understanding embryonic development for enhanced surgical planning and execution.

Main Methods:

• Utilizing "reverse embryonic development" logic to understand primitive gut rotation, mesenteric fusion, and fascia formation.
• Applying principles of total mesentery excision, mesenteric blood supply interruption, and extra-mesenteric preservation.
• Validating the approach through radical right hemicolectomy and radical gastrectomy procedures.

Main Results:

• Demonstrated the ability to define surgical boundaries and anatomical landmarks based on embryonic development.
• Showcased reduced operational difficulty and improved reproducibility in radical gastrointestinal surgeries.
• Integrated en-bloc resection with organ function preservation by leveraging embryonically formed fascial spaces.

Conclusions:

• Gastrointestinal developmental anatomy surgery offers a theoretical basis for improving radical gastrointestinal tumor resections.
• This approach enhances surgical standardization, reduces complexity, and improves functional outcomes.
• Understanding embryonic development is key to advancing surgical techniques in gastrointestinal oncology.