Anatomic Basis of Sharp Pelvic Dissection for Curative Resection of Rectal Cancer.
10.3349/ymj.2005.46.6.737
- Author:
Nam Kyu KIM
1
Author Information
1. Department of Surgery, Division of Colorectal Surgery, Colorectal Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Review ; Research Support, Non-U.S. Gov't
- Keywords:
Rectal cancer;
sharp pelvic dissection;
rectal proper fascia;
mesorectum;
pelvic autonomic nervous system
- MeSH:
Rectum/pathology/*surgery;
Rectal Neoplasms/pathology/*surgery;
Pelvis/*surgery;
Magnetic Resonance Imaging;
Humans;
Dissection/methods
- From:Yonsei Medical Journal
2005;46(6):737-749
- CountryRepublic of Korea
- Language:English
-
Abstract:
The optimal goals in the surgical treatment of rectal cancer are curative resection, anal sphincter preservation, and preservation of sexual and voiding functions. The quality of complete resection of rectal cancer and the surrounding mesorectum can determine the prognosis of patients and their quality of life. With the emergence of total mesorectal excision in the field of rectal cancer surgery, anatomical sharp pelvic dissection has been emphasized to achieve these therapeutic goals. In the past, the rates of local recurrence and sexual/ voiding dysfunction have been high. However, with sharp pelvic dissection based on the pelvic anatomy, local recurrence has decreased to less than 10%, and the preservation rate of sexual and voiding function is high. Improved surgical techniques have created much interest in the surgical anatomy related to curative rectal cancer surgery, with particular focus on the fascial planes and nerve plexuses and their relationship to the surgical planes of dissection. A complete understanding of rectum anatomy and the adjacent pelvic organs are essential for colorectal surgeons who want optimal oncologic outcomes and safety in the surgical treatment of rectal cancer.
