Summary
Detailed dissections were performed on 83 pelvic halves from 45 cadavers in order to obtain more accurate data on the composition of the lateral ligament of the rectum and the rectosacral fascia. The middle rectal artery was observed in only 18 out of 81 spcimens (22.2%). The lateral ligament of the rectum was divided into lateral and medial portions, according to the positional relationship to the pelvic plexus. The lateral part consisted of a superoanterior and an inferoposterior subdivision. The main component of the former was the middle rectal artery, while the pelvic splanchnic nerves were contained in the latter. Both components can be considered to contribute to the formation of the medial part, although the middle rectal vessels were not always present. The medial part consisted of the rectal branches from the pelvic plexus and their connective tissue. The rectosacral fascia was formed by dense connective tissue between the posterior wall of the rectum and the third and fourth sacral vertebrae. The main components of the fascia were branches of the lateral and median sacral vessels and the sacral splanchnic nerves which arose directly from the sacral sympathetic ganglia.
Résumé
La dissection de 83 hémibassins provenant de 45 cadavres a été réalisée pour préciser la structure du ligament latéral du rectum et du fascia recto sacré. L'artère rectale moyenne (ARM) a été observée seulement sur 18 specimens (22,2 %). Le ligament latéral du rectum a été divisé en portion latérale et médiale, en fonction des rapports topographiques avec le plexus pelvien. La partie latérale présente une portion antérosupérieure contenant l'ARM et une portion postéro-inférieure contenant les nerfs splanchniques pelviens (NSP). Ces deux composants (ARM et NSP) contribuent à la formation de la partie médiale bien que les vaisseaux rectaux moyens ne soient pas toujours présents. La partie médiale répond aux branches rectales du plexus pelvien et à leurs tissus conjonctifs environnants. Le fascia sacro-rectal est formé de tissu conjonctif dense, tendu de la paroi postérieure du rectum aux 3e et 4e vertèbres sacrées. Les principaux composants de ce fascia sont les branches latérales et médiales des vaisseaux sacrés et les nerfs splanchniques sacrés arrivant directement des ganglions sympathiques sacrés.
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Sato, K., Sato, T. The vascular and neuronal composition of the lateral ligament of the rectum and the rectosacral fascia. Surg Radiol Anat 13, 17–22 (1991). https://doi.org/10.1007/BF01623135
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DOI: https://doi.org/10.1007/BF01623135