title: Proximal segmentation of the dorsal mesogastrium reveals new anatomical implications for laparoscopic surgery.
abstract: Generally, the gold standard of radical surgery for gastrointestinal (GI) tumors is en bloc resection of primary lesions and their related tissues. For gastric cancer, the ideal surgical treatment should be D2 radical gastrectomy plus complete mesogastrium excision. Complete mesogastrium excision is rarely done or mentioned since little is known about the mesogastrium and its presence is still with controversy. Topographically, the "mesogastrium" refers to a peri-gastric structure composed of "fascia propria", enveloping lymph nodes, blood vessels and adipose tissues, which by connecting to the stomach, suspends from the posterior abdominal wall. In this study, by employing video laparoscopy, a number of proximal segments of dorsal mesogastrium were found being extensively scattered around the pancreas. The structure of the mesogastrium was further identified intraoperatively and then confirmed both grossly and histologically after the operation. Our results demonstrated the existence of mesogastrium (gastric mesentery) and its architecture. We suggest for the first time a "Table model" to describe the relationship between the stomach and gastric mesenteries enveloped by fascia propria, which might provide an improvement in the surgical methods for excision of gastric cancer.
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Daxing
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Chun
authors.initials: C
authors.lastname: Gao
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: An
authors.initials: A
authors.lastname: Lu
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Chaoran
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Junbo
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR. China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Gong
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008643:Mesentery / Q000601:surgery; D008875:Middle Aged; D011247:Pregnancy; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*