Surgical and Radiologic Anatomy

, Volume 21, Issue 5, pp 319–324 | Cite as

The surgical anatomy of the fasciae and the fascial spaces related to the rectum

  • V. Muntean
Original Articles

Summary

The perirectal fasciae and their vascular and neural relationships were studied based on the dissection of 46 fresh cadavers. The rectal fascia is a tubular sleeve, areolar in nature, which houses the superior rectal vessels and lymphatics. The nerves which supply fibres to the pelvic plexus run close to the rectum, contained in the urogenital and presacral fasciae. The rectum is attached to these two fasciae by the rectal stalks, which take a spiral course round the rectum, being posterolateral in the upper rectum, lateral in the mid-rectum and anterolateral in the lower rectum. During rectal resection the pelvic nn. may be preserved if the rectal dissection proceeds close to the rectal fascia. After cutting the rectal insertion of the presacral fascia, the lower rectal stalks (paraproctium) come into direct view and can be divided close to the rectal wall with no risk of damage to the pelvic plexus.

Key words

Rectum Anatomy Fascia Pelvis Nerves 

Anatomie chirurgicale des fascias et espaces en rapport avec le rectum

Résumé

Les fascias péri-rectaux et leurs rapports vasculo-nerveux ont été étudiés par dissection de 46 cadavres frais. Le fascia rectal est un manchon tubulaire, de nature aréolaire, qui enveloppe les vaisseaux rectaux supérieurs et les lymphatiques. Les nerfs qui alimentent le plexus pelvien courent près du rectum, contenus par les fascias uro-génital et pré-sacré. Le rectum est relié à ces deux fascias par les ailerons du rectum, dont le trajet en spirale est postéro-latéral à la partie haute du rectum, latéral à sa partie moyenne, antéro-latéral à sa partie inférieure. Au cours des résections rectales, il est possible de respecter les nerfs pelviens si la dissection du rectum est menée au ras du fascia rectal. Après avoir coupé l'insertion rectale du fascia présacré, les ailerons rectaux inférieurs (paraproctium) sont directement visibles et peuvent être sectionnés au ras de la paroi rectale sans risque de lésion du plexus pelvien.

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Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • V. Muntean
    • 1
  1. 1.Department of Surgery, IV Surgical ClinicUniversity of MedicineClujRomania

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