Mesentery

肠系膜
  • 文章类型: English Abstract
    Anatomy is the foundation of surgery. However, traditional anatomical concepts based on autopsy are no longer sufficient to guide the development of modern surgery. With the advancement of histology and embryology and application of high-resolution laparoscopic technology, surgical anatomy has gradually developed. Meanwhile, some important concepts and terms used to guide surgery have emerged, including: mesentery, fascia, and space. The confusing, controversial, and even inaccurate definitions and anatomical terms related to colorectal surgery seriously affect academic communication and the training of young surgeons. Therefore, the Chinese Society of Colorectal Surgeons, the Chinese Society of Colorectal Surgery, National Health Commission Capacity Building and Continuing Education Center, and China Sexology Association of Colorectal Functional Surgery organized colorectal surgeons to make consensus on the definition and terminology of mesentery, fascia, and space related to colon and rectum, to promote surgeons\' understanding of modern anatomy related to colorectal surgery and promote academic communication.
    解剖学是外科手术的基础,但基于尸体解剖的传统解剖学概念已经不足以指导现代外科手术的开展。随着组织胚胎学的深入研究和高分辨率腹腔镜下临床解剖的开展,外科医师对人体解剖的认知不断更新,同时也出现了用于指导外科手术的重要概念和名词,包括系膜、筋膜和间隙等。但是,这些概念和名词在不同时代涵义不同,同一名词命名不同,同一解剖结构在不同部位命名也不同,对国内学术交流及青年医师的培养十分不利。鉴于此,中国医师协会外科医师分会结直肠外科医师专业委员会、中华医学会外科学分会结直肠外科学组、国家卫生健康委员会能力建设和继续教育外科学专家委员会结直肠外科专业委员会和中国性学会结直肠肛门功能外科分会共同牵头,组织全国结直肠外科专家,对结直肠手术相关的系膜、筋膜和间隙进行统一的描述和命名,以使外科医师更加深入地理解结直肠手术相关的现代解剖学,并促进学术交流。.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    Disorders of the mesenteric, portal, and hepatic veins and mesenteric and hepatic arteries have important clinical consequences and may lead to acute liver failure, chronic liver disease, noncirrhotic portal hypertension, cirrhosis, and hepatocellular carcinoma. Although literature in the field of vascular liver disorders is scant, these disorders are common in clinical practice, and general practitioners, gastroenterologists, and hepatologists may benefit from expert guidance and recommendations for management of these conditions. These guidelines represent the official practice recommendations of the American College of Gastroenterology. Key concept statements based on author expert opinion and review of literature and specific recommendations based on PICO/GRADE analysis have been developed to aid in the management of vascular liver disorders. These recommendations and guidelines should be tailored to individual patients and circumstances in routine clinical practice.
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  • 文章类型: Journal Article
    OBJECTIVE: According to new Dutch guidelines for rectal cancer, MRI-defined tumour stage determines whether preoperative radiotherapy is indicated. Therefore, we sought to evaluate if preoperative MRI accurately predicts the indication for neoadjuvant treatment in rectal cancer cases in daily practice according to the new Dutch guidelines.
    METHODS: Data for all rectal cancer patients who underwent mesorectal excision in our hospital, between January 2011 and January 2018 were collected retrospectively. We compared histopathologic outcome with tumour staging on preoperative MRI for patients who received no radiotherapy prior to resection or short-course radiotherapy directly followed by resection.
    RESULTS: Of 223 patients treated according to the old guidelines, 94% received neoadjuvant therapy. Of 301 patients treated according to the new guidelines, only 49% did. Under the old guidelines, MRI predicted lymph node metastases with a sensitivity of 74.2% and a specificity of 52.6%. With the new guidelines, sensitivity was 47.5% and specificity was 77.3%. The new guidelines resulted in 45% more patients not being exposed to disadvantages of radiotherapy, but 13% of all patients were undertreated.
    CONCLUSIONS: Concordance between clinical lymph node staging on preoperative MRI and histopathologic staging is limited, resulting in many rectal cancer patients not receiving adequate neoadjuvant therapy.
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  • 文章类型: Consensus Development Conference
    Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn\'s disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn\'s Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn\'s disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn\'s disease. This work makes recommendations for imaging findings that indicate small bowel Crohn\'s disease, how inflammatory small bowel Crohn\'s disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn\'s disease and considered for small bowel Crohn\'s disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented. ©2018, RSNA, AGA Institute, and Society of Abdominal Radiology This article is being published jointly in Radiology and Gastroenterology.
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  • 文章类型: Case Reports
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