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右半结肠切除术的中间入路:回结肠血管被拉伸并且在所产生的腹膜皱褶的基部开始腹膜切开。腹膜前叶的解剖沿着SMA左边缘进行;在SMV前部行整体淋巴结清扫术,沿着肾前筋膜平面从内侧到外侧和从底部到顶部。Toldt筋膜的解剖胚胎平面被锐性分离:内测分离通常沿肝曲的结肠系膜与胰十二指肠前筋膜之间的平面解剖;外侧通过切开结肠肝曲外侧腹膜返折进入上述平面,在这个水平的结肠筋膜囊相互衔接,可以容易的分离。分离过程中确保右半结肠系膜完整性及保护腹膜后结构,如右输尿管和性腺血管。右侧腹膜返折和回盲部腹膜返折逐渐分离后使右半结肠标本完全游离。
Mid-right hemi-colectomy: The ileocolonic vessels are stretched and the peritoneal incision is started at the base of the resulting peritoneal fold. Anatomy of the anterior peritoneal lobe was performed along the left margin of the SMA; an entire lymph node dissection was performed anterior to the SMV, medial to lateral along the prerenal fascia, and from the bottom to the top. Toldt fascia anatomical embryo plane was sharp separation: closed beta dissection usually along the hepatic degeneration of the mesentery and pancreatic duodenal anterior fascia between the plane; outside by cutting off the liver outside the liver peritoneal reentry fold into the above Plane, at this level of the colon fascia sac connected to each other, can be easily separated. Separation process to ensure the integrity of the right half of the mesentery and the protection of retroperitoneal structures, such as the right ureter and gonadal vessels. Right peritoneal reentry and ileocecal peritoneal reentrant gradually separated the right half colon specimens completely free.