在胃癌手术期间门静脉合流的变化:两个病例报告
Sa-Hong Kim1, Franco José Signorini2, Kyoyoung Park1
1Department of Surgery, Seoul National University Hospital, Seoul, Korea.
Korean journal of clinical oncology
|May 9, 2025
概括
肝外门静脉异常可以使胃癌手术复杂化,影响淋巴结解剖. 术前成像对于识别这些血管变异至关重要,以确保患者的安全和手术精度.
科学领域:
- 手术瘤学手术瘤学
- 血管解剖学 血管解剖学
- 医疗成像医学成像
背景情况:
- 胃癌手术需要细致的淋巴结 (LN) 剖析,以准确的分期和治疗.
- 解剖学变异,特别是在主要血管中,在手术过程中可能会带来重大挑战.
- 肝外门静脉异常很少见,但可能使手术方法复杂化.
研究的目的:
- 要突出在胃癌手术中淋巴结解剖期间,肝外门静脉异常所带来的挑战.
- 强调手术前识别血管异常对于手术规划的重要性.
- 展示增强成像在导航复杂的外科解剖学中的实用性.
主要方法:
- 介绍两个不同的病例,涉及胃癌手术期间的肝外门静脉异常.
- 使用近红外线 (NIR) 淋巴血管学与氨酸绿色用于淋巴图谱.
- 由于解剖学复杂性,在一个案例中使用了NIR成像的连续淋巴导航.
主要成果:
- 一个意想不到的肝外门静脉合流异常和异常的常见肝动脉导致试验排除,但指导手术方法.
- 在第二个案例中,前置的脊髓静脉阻碍了沿左胃动脉的淋巴结解剖.
- 证明了血管异常可能影响标准手术方案,并需要修改技术.
结论:
- 术前识别胃周围的大血管异常对于预防胃癌手术期间的并发症至关重要.
- 增强成像技术,如NIR淋巴血管学,可以提高复杂解剖的瘤安全性和精度.
- 对于进行胃癌切除的外科医生来说,意识到罕见的血管变异是必不可少的.
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