Fusion fascia and their role in surgery of locally advanced colon tumors.
1. Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Budapest street, 3, Saint Petersburg, Russian Federation.
2. S. M. Kirov Military medical Academy, Russian Federation, Saint Petersburg, street of Academician Lebedev, 6.
3. FGBU "413 VG" of the Ministry of defense of the Russian Federation, Volgograd, 81 Marshal Zhukov Ave.
4. OGBUZ "Kostroma oncological dispensary", Kostroma, Nizhnyaya debrya str., 19.
The need to simultaneously ensure a high degree of safety of surgical intervention and an adequate level of its radicalism makes it expedient to widely apply modern principles of operative surgery based on an applied understanding of the topographical and anatomical features of the structure of the posterior abdominal wall. Modern concepts of "embryologically based" operative surgery, based on the fact of the existence of "fusion fascia", allow you to choose a single surgical approach and successfully apply it in one of the most complex areas of visceral surgery, which is the surgery of complicated colorectal cancer. The fusion fascia is a loose connective tissue formed as a result of the close interaction of the primary leaves of the peritoneum, which were at the early stages of embryogenesis in a free relation, and subsequently exist as a single structure. The latter is represented at the histological level in an adult by two reduced plates (the former parietal and visceral primary peritoneum) and an avascular layer of loose connective tissue located between them. This approach naturally leads to an increase in the number of R-0 resections and an improvement in the quality of control over the regional lymphatic apparatus of the affected colon, which, in turn, can potentially improve the long-term results (General and relapse-free survival) of surgical treatment of this category of patients.
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