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Is it possible to give a single definition of the rectosigmoid junction?

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Abstract

Aim

The rectosigmoid junction is the limit separating the sigmoid colon and rectum. This transition zone has different definitions. We want to highlight different landmarks of the rectosigmoid junction (RSJ), to help the clinicians to adopt a consensual definition.

Method

We reviewed anatomical, endoscopic, physiological and surgical points of view concerning the rectosigmoid junction (RSJ).

Results

The rectosigmoid junction has a different definition depending on who is studying it. Nevertheless, it is a high pressure location, a place connecting different muscles organizations, neurological systems or vascular anastomosis. The clear pathophysiology of the RSJ is not yet determined with certainty, but its resection is essential for the therapeutic care of patients and also for the improvement of surgical skills. From a surgical point of view, anatomical landmarks has to be chosen: easily reproducible and identifiable. The disappearance of taenia coli (belonging to the colon) and the peritoneal reflection (recto-genital pouch), located below the upper rectum, seem the most reliable. The level of rectal section must, in any case, be below the promontory.

Conclusion

There is not a single definition, but rather several definitions of the RSJ. Each one of them reflects one appearance of this region: embryological and anatomical evolution or clinical entity. From a surgical point of view, the criterion which seems to be the most reliable is the disappearance of taenia coli and the peritoneal reflection (recto-genital pouch).

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Acknowledgements

We thank Mr Brian Collins for his assistance in editing the article, and Mr Benjamin Maes for his drawings.

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Authors and Affiliations

  1. Acute Care Surgery, Chirurgie Générale d’Urgencen Universitary Hospital of Nice, Hôpital Pasteur 2, Nice Sophia-Antipolis University, 30 voie romaine, 06000, Nice, France

    Damien Massalou, Daniela Mariage & Patrick Baqué

  2. Biomechanical Applied Laboratory, UMRT24, IFSTTAR, Aix-Marseille University, Marseille, France

    Damien Massalou

  3. Institute of Anatomy, Medical school of Nice, Nice Sophia-Antipolis University, Nice, France

    Damien Massalou, Patrick Baqué, Olivier Camuzard & Nicolas Bronsard

  4. AP-HP, Hôpital Ambroise Paré, Service de chirurgie digestive, oncologique et métabolique, 92100, Boulogne-Billancourt, France

    David Moszkowicz

  5. UVSQ, Université Paris Saclay, UFR des sciences de la santé Simone Veil, 78180, Montigny-Le-Bretonneux, France

    David Moszkowicz

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  1. Damien Massalou
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  2. David Moszkowicz
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Correspondence to Damien Massalou.

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Massalou, D., Moszkowicz, D., Mariage, D. et al. Is it possible to give a single definition of the rectosigmoid junction?. Surg Radiol Anat 40, 431–438 (2018). https://doi.org/10.1007/s00276-017-1954-4

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  • DOI: https://doi.org/10.1007/s00276-017-1954-4

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