[Development of membrane anatomy theory in gastric cancer surgery].

In the past decade, the concept of membrane anatomy has been gradually applied in gastric cancer surgery. Based on this theory, D2 lymphadenectomy plus complete mesogastric excision (D2+CME) has been proposed, which has been demonstrated to significantly reduce intraoperative bleeding and intraperitoneal free cancer cells during surgery, decrease surgical complications, and improve survival. These results indicate that membrane anatomy is feasible and efficacious in gastric cancer surgery. In this review, we will describe the important contents of membrane anatomy, including "Metastasis V"(2013, 2015), proximal segmentation of dorsal mesogastrium (2015), D2+CME procedure (2016), "cancer leak"(2018), and surgical outcomes of D2+CME (2022).在过去的十年里，膜解剖的理念逐步运用于胃癌外科手术领域。基于膜解剖理论提出的D2淋巴结清扫加完整胃系膜切除术（D2+CME）被一系列研究证实，不仅可以减少术中出血，降低手术风险，还可以有效降低腹腔内肿瘤细胞扩散，从而改善肿瘤预后。因此，基于膜解剖理论的D2+CME在胃癌外科治疗中具有可行性及有效性。为了清晰描述膜解剖理论研究在胃癌根治领域的发展历程，本文将简要回顾其几个关键过程，包括“第五转移”的证明（2013年和2015年）、胃背侧系膜近侧段（PSDM）的论证（2015年）、D2+CME手术的建立（2016年）、癌泄漏检测（2018年）以及D2+CME手术的外科学疗效（2021年和2022年）。.