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The parasympathetic supply to the distal colon—one marker for precisely locating the posterior dissection plane in the operation of TME
Author(s) -
Dongsong Bi,
Tao Li,
Kexin Wang,
Haidong Gao,
Sanyuan Hu
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21529
Subject(s) - medicine , rectum , dissection (medical) , anatomy , fascia , total mesorectal excision , surgery , colorectal cancer , cancer
Background It is important for surgeons to locate the reliable surgical planes in the operation of total mesorectal excision (TME); we observe the parasympathetic nerve to the distal colon can be served as one of useful markers for precisely locating the posterior dissection plane in TME. Materials and Methods From October 2006 to January 2008, 26 patients underwent TME for rectal cancer. The dissections of the parasympathetic nerves to the distal colon were performed and the relationship of these nerves to the prehypogastric nerve fascia was observed. Results Some parasympathetic nerves ran upwards and lay anteromedial to the hypogastric nerves. In the avascular space between prehypogastric nerve fascia and the fascia propria of the rectum, the prehypogastric nerve fascia enveloped parasymphathetic nerve up to the fascia propria of rectum. Conclusions The parasympathetic nerve to the distal colon is evident between the fascia propria of the rectum and the prehypogastric nerve fascia. As the precise dissection plane of TME lay between the fascia propria of the rectum and the prehypogastric nerve fascia, these nerves could be served as useful marker for precisely locating the posterior dissection plane in TME. J. Surg. Oncol. 2010; 101:524–526. © 2010 Wiley‐Liss, Inc.