Mechanism and anatomy recognition of neurovascular bundle injury from different perspectives of transab?dominal and transanal approach
10.3760/cma.j.issn.1671?0274.2019.10.008
- VernacularTitle:经腹及经肛不同视角下的神经血管束损伤机制及解剖学认识
- Author:
Jinchun CONG
1
;
Hong ZHANG
Author Information
1. 中国医科大学附属盛京医院结直肠肿瘤外科
- Keywords:
Neurovascular bundle;
Total mesorectal excision;
Transanal total mesorectal excision;
Anatomy
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(10):943-948
- CountryChina
- Language:Chinese
-
Abstract:
The neurovascular bundle (NVB) starts at the lateral angle of the seminal vesicle (the initial part), passes posterolateral of the prostate gland (the main part), and ends at the cavernous body of the penis (the cavernous part). In low rectal surgery, different transabdominal and transanal perspectives result in different NVB injury risks. In the perspective of transabdominal operation, the separation between the initial part of NVB and Denonvilliers fascia and the anatomical variation of the two lateral sides of Denonvilliers fascia increases the risk of NVB injury, and conformation separation may take into account the convenience of separationand the protection of NVB. In the perspective of transanal operation, when separating the main part with NVB and mesorectum, the perspective of the transanal, unidirection traction and excessive dissection increase the risk of NVB main exposure. Clear anatomical identification helps the protection of NVB in the transanal operation. At present, the medical evidence on the difference of NVB injury in different perspectives of transabdominal and transanal approach is still in need of relevant clinical researches.
