? ↓ Click to watch the video ↓
Guest of this issue
Gong Jianping.
Director of tongji hospital Institute of Gastrointestinal Oncology, Huazhong University of Science and Technology
Member of Surgery Branch of Chinese Medical Association, deputy head of Experimental Surgery Group of Chinese Medical Association.
1 membrane anatomy and the fifth metastasis
20 17 global cancer survey report shows that gastrointestinal cancer is the main killer of human health, ranking second among malignant tumors. The mortality of gastrointestinal cancer remains high, and the incidence of colorectal cancer is rising gradually, which leads to the severe situation of gastrointestinal cancer treatment. Except for a few developed countries, once gastrointestinal tumors are found in the advanced stage, although there are so-called precision medicine and biomedicine, so far, the first choice for treatment is surgery, and the only way to cure them is surgery.
In the past, people thought that radical resection of tumor meant complete resection of tumor. Later, it was found that it was not enough to remove the primary focus of the tumor. Resection of the primary tumor can not improve the prognosis of the tumor because of recurrence. As a result, lymph node metastasis has entered people's field of vision, and primary focus resection and lymph node dissection have begun, but the results of this are still limited. Why? Many patients with negative lymph node metastasis still have local recurrence after operation. Where do the seeds of local recurrence come from? As a result, a new anatomy slowly entered our eyes, and a new metastasis began to be recognized by us. This is membrane anatomy, the fifth metastasis.
2 Break the curse of cancer leakage
Although the understanding of various "membranes" in the human body has been described for a long time, it is rarely associated with surgery, and the spread of cancer cells in the membrane is not recognized. In traditional surgical anatomy, there are only descriptions of mesentery, transverse mesocolon and part of sigmoid mesocolon, but there are no descriptions of ascending colon, descending colon and mesorectum, and there is no description of gastric mesentery or other organ mesangium.
As early as 1982, there was total mesorectal excision abroad, and it appeared in 2009. These two operations are one of the important clues to the formation of membrane anatomy today. The blood vessels and organs of the human body are surrounded by a membrane, and the surgical approach with less bleeding is between these two membranes. Not breaking this membrane during the operation can protect the organs and blood vessels inside, and can also prevent cancer cells from scattering into the operation field when the tumor is removed, resulting in' missing cancer'. The theory of "membrane anatomy" is also applicable to other organs and most surgical operations.
The advantages of operation based on membrane anatomy are: less bleeding and less cancer leakage; There are few surgical complications and low postoperative recurrence rate.
My feeling is three deposits.
On 20 13, Professor Gong Jianping's team put forward the theory of "membrane anatomy" and "submicroscopic surgery" for the first time in the world, and applied it to 3D laparoscopic gastrointestinal tumor surgery. With the high definition and enlargement of 3D laparoscopy, the theories of "membrane anatomy" and "submicroscopic surgery" have been confirmed in practical operations, namely laparoscopic total gastrectomy and laparoscopic right hemicolectomy, both of which are the first in the world.
In 20 15, at the 4th Eurasian Colorectal Cancer Summit and the 9th Russian International Conference on Colorectal Cancer, Professor Gong Jianping led his team to give a live demonstration of the operation under the observation of more than 1,000 experts from 1000 countries around the world, which won the admiration of the experts. Over the past six years, Professor Gong Jianping's team has given live demonstrations and invited speeches in Russian, Italian, American, German, British, Japanese, Korean and other countries.
? "My feeling is three rescues-three rescues: the first one saved more patients and broke the curse and nightmare of' it is better not to have surgery, but to act quickly after surgery'; The second rescue, because of the anatomy of the membrane, made our operation tend to micro-bleeding, or even zero bleeding, saving the surgeon from trudging in bloody; The third rescue is to save ourselves, not to be mixed with some unscientific, unscientific, pseudoscientific and anti-scientific things, and to constantly reshape our surgery with scientific things. "
MED24 medical media is aimed at doctors and medical students and is committed to building the most influential medical video information platform in China. Stay tuned.
Edit | Ziyi
Video | Green Pepper Media
Final review | Wang Yanan