引用文本：赵玉洲, 张鑫, 张习杰. 膜解剖理论的兴盛与式微：外科领域的理论演进与挑战[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(2):189-194.

作者：赵玉洲，张鑫，张习杰

单位：郑州大学附属肿瘤医院（河南省肿瘤医院） 普外科，河南 郑州 450008

Authors：Zhao Yuzhou, Zhang Xin, Zhang Xijie

Unit：Department of General Surgery, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, Henan, China

摘要：

膜解剖理论作为现代外科解剖学理论体系中的重要组成部分，其源于传统解剖学理论的积淀，经多年发展，凭借其在消化道肿瘤手术中的独特优势，提高了手术精准性和安全性。伴随着腹腔镜及机器人技术在临床手术中的广泛应用，膜解剖逐渐形成了更为系统和全面的理论体系。它从全新的视角对人体组织结构进行解读，为外科手术提供了更为精准、细致的解剖依据。随着膜解剖新概念在临床运用中不断得到验证和丰富，膜解剖理论体系更加成熟。然而，随着医学研究的不断深入和临床实践的持续推进，解剖结构的复杂性和个体差异、解剖偏移问题、新辅助治疗对膜解剖范围及解剖层次的影响以及新辅助治疗后病理完全缓解患者的手术与否问题日益突出，导致其在膜界特性、与根治性手术及免疫治疗关系等方面遭遇困境，在肿瘤治疗全过程中的适用局限性也逐渐凸显。本文深入剖析了膜解剖理论的兴起、发展、鼎盛及面临的局限性与挑战，为膜解剖理论的完善和应用提供证据支持，使其在不断发展的医学领域中保持生命力。

关键词：膜解剖；外科手术；挑战

Abstract：

As an important part of the modern surgical anatomy theory system, the theory of membrane anatomy originates from the accumulation of traditional anatomical theories, and has been developed for many years to improve the accuracy and safety of surgery with its unique advantages in gastrointestinal tumor surgery. With the widespread application of laparoscopic and robotic technology in clinical surgery, a more systematic and comprehensive theoretical system has gradually been formed. It interprets the human tissue structure from a new perspective and provides a more accurate and detailed anatomical basis for surgery. As the new concept of membrane anatomy is continuously verified and enriched in clinical applications, the theoretical system of membrane anatomy becomes more mature. However, with the continuous deepening of medical research and the continuous advancement of clinical practice, the complexity and individual differences of anatomical structure, the problem of anatomical deviation, the influence of neoadjuvant therapy on the range and hierarchy of membrane anatomy, and the problem whether patients with pathological complete remission after neoadjuvant therapy should undergo surgery have become increasingly prominent, leading to difficulties in membrane boundary characteristics and its relationship with radical surgery and immunotherapy. The limitations of application in the whole process of tumor treatment are also gradually prominent. This paper makes an in-depth analysis of the rise, development, heyday and limitations and challenges of membrane anatomy theory, providing evidence support for the improvement and application of membrane anatomy theory, and maintaining its vitality in the ever-developing medical field.

Key words：Membrane anatomy; Surgery; Challenge

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