Anatomy research on Denonvilliers fascia and its significance in nerve-preservation rectal cancer surgery.
10.3760/cma.j.cn.441530-20210113-00019
- Author:
Hong Bo WEI
1
;
Jia Feng FANG
1
Author Information
1. Department of Gastrointestinal Surgery, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
- Publication Type:Review
- Keywords:
Denonvilliers fascia;
Innovative TME (iTME);
Pelvic autonomic nerve;
Rectal neoplasms;
Sexual dysfunction;
Urinary dysfunction
- MeSH:
Autonomic Pathways;
Fascia;
Humans;
Male;
Multicenter Studies as Topic;
Pelvis/surgery*;
Quality of Life;
Randomized Controlled Trials as Topic;
Rectal Neoplasms/surgery*;
Rectum/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2021;24(4):301-305
- CountryChina
- Language:Chinese
-
Abstract:
Urinary and sexual dysfunctions due to intraoperative pelvic autonomic nerve injury have become the most common complications of rectal cancer surgery, seriously affecting postoperative quality of life. How to protect the nerve and urogenital function while ensuring radical resection for rectal cancer has become the focus of research. We previously carried out a series of systematic studies on Denonvilliers fascia, an important anatomical structure closely related to protection of pelvic autonomic nerve, and demonstrated the importance of Denonvilliers fascia in preservation of intraoperative pelvic autonomic nerve and protection of postoperative urogenital function from aspects of anatomy, physiology, tissue, operation practice and so on. Meanwhile, based on the interim results of our multicenter randomized controlled study, we confirmed that total mesorectal excision with preservation of Denonvilliers fascia (innovative TME, iTME) could effectively reduce the incidence of postoperative urinary and sexual dysfunctions in male patients with mid-low rectal cancer, without sacrificing oncologic outcome. In this article, combined with our research results, we review the literature on anatomy research progress of Denonvilliers fascia to demonstrate the significance and research prospect of Denonvilliers fascia in the pelvic autonomic nerve preservation surgery for rectal cancer.
