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Vascular Anatomy of the Rectal Stump After Total Mesorectal Excision

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Diseases of the Colon & Rectum

Purpose

For many years, poor vascularization of the short rectal stump has been considered the main cause of leakage. The purpose of this study was to evaluate the vascularization of the rectal stump after total mesorectal excision.

Methods

We studied the iliac vascularization on 28 volunteers with healthy rectum to have an anatomic basis. Then, we studied the vascularization of the rectal stumps after total mesorectal excision by using angio computed tomography at seven and three months after operating on 22 patients; we validated this technique by studying the vascularization using angio computed tomography in 18 rectal specimens from cadavers.

Results

Both in healthy rectums and in rectal stumps after total mesorectal excision, there is good vascularization substained by middle and inferior rectal arteries. The former is more important and frequent as described in previous literature.

Conclusions

The vascularization of the short rectal stump is generally well represented even after total mesorectal excision.

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Authors and Affiliations

  1. Department of Clinical Pathophysiology, III Section of General Surgery, University of Turin, Via Genova 3, Turin, 10126, Italy

    Mario Nano M.D., Marco Ferronato M.D., Mario Solej M.D. & Marcello Dei Poli M.D.

  2. Department of Medical and Surgical Sciences, Institute of Diagnostic and Interventional Radiology, University of Turin, Turin, Italy

    Filippo Marchisio M.D., Andrea Doriguzzi Breatta M.D., Stefano Barbero M.D. & Giovanni Gandini M.D.

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  1. Mario Nano M.D.
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  2. Filippo Marchisio M.D.
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  3. Marco Ferronato M.D.
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Correspondence to Mario Nano M.D..

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Nano, M., Marchisio, F., Ferronato, M. et al. Vascular Anatomy of the Rectal Stump After Total Mesorectal Excision. Dis Colon Rectum 49, 1897–1904 (2006). https://doi.org/10.1007/s10350-006-0734-8

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