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Identification of the surgical indication line for the denonvilliers’fascia and its anatomy in patients with rectal cancer

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Cancer Communications 2020年第1期40卷 25-31页

作者： Jianglong Huang Jing Liu Jiafeng Fang Zongheng Zeng Bo Wei Tufeng Chen Hongbo Wei Department of Gastrointestinal Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630GuangdongP.R.China Department of Human Anatomy Histology and EmbryologyGuangdong Pharmaceutical UniversityGuangzhou 510006GuangdongP.R.China

Background:The high rate of urogenital dysfunction after traditional total mesorectal excision(TME)has caused doubts among scholars on the standard fashion of *** have proposed the necessity to preserve the denonvilliers’fascia in patients with rectal ***,how to accurately locate the denonvilliers’fascia is *** study aimed to explore anatomical features of the denonvilliers’fascia by comparing autopsy findings and observations of surgical videos so as to propose a dissection method for the preservation of pelvic autonomic nerves during rectal cancer ***:Five adult male cadaver specimens were dissected,and surgical videos of 135 patients who underwent TME for mid-low rectal cancer between January 2009 and February 2019 were reviewed to identify and compare the structure of the denonvilliers’***:The monolayer structure of the denonvilliers’fascia was observed in 5 male cadaver specimens,and it was located between the rectum,the bottom of the bladder,the seminal vesicles,the vas deferens,and the *** denonvilliers’fascia was originated from the rectovesical pouch(or rectum-uterus pouch),down to fuse caudally with the rectourethral muscle at the apex of the prostate,and fused to the lateral ligaments on both *** fascia was thinner on the midline with a thickness of 1.06±0.10 *** crown shape of the denonvilliers’fascia was slightly triangular,with a height of approximately 5.42±0.16 cm at *** were more densely distributed in front of the denonvilliers’fascia than behind,especially on both sides of *** laparoscopic view,the denonvilliers’fascia was originated at the lowest point of the rectovesical pouch(or rectum-uterus pouch),with a thickened white line which was a good mark for identifying the denonvilliers’***:Identification of the surgical indication line for the denonvilliers’fascia could help us identify the denonvilliers’fascia,and it would improve our ability to pr

关键词： cadaver dissection laparoscopic surgery pelvic autonomic nerve preservation rectal cancer the denonvilliers’fascia total mesorectal excision

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