https://scholars.lib.ntu.edu.tw/handle/123456789/431411
標題: | Anatomical basis of rectal cancer surgery focused on pelvic fascia | 作者: | JIN-TUNG LIANG | 關鍵字: | Denonvilliers' fascia | Endopelvic fascia (parietal layer of pelvic fascia) | Gerota fascia | Presacral fascia | Proper fascia of the rectum | Rectosacral fascia | Toldt fascia | Waldeyer's fascia;Denonvilliers' fascia; Endopelvic fascia (parietal layer of pelvic fascia); Gerota fascia; Presacral fascia; Proper fascia of the rectum; Rectosacral fascia; Toldt fascia; Waldeyer's fascia | 公開日期: | 2-五月-2018 | 來源出版物: | Surgical Treatment of Colorectal Cancer: Asian Perspectives on Optimization and Standardization | 摘要: | © Springer Nature Singapore Pte Ltd. 2018. All rights reserved. Fascial structures are the natural embryonic dissection plane for the precise surgery of rectal cancer. This chapter characterized the fascial structures implicated in the rectal cancer surgery, which include Toldt fascia, Denonvilliers' fascia, proper fascia of the rectum, endopelvic fascia (parietal layer of pelvic fascia), presacral fascia, rectosacral fascia, and Waldeyer's fascia. Toldt fascia is the extension of Gerota fascia and constitutes the natural dissection plane for the mobilization of left colon. The whole mesorectum was enclosed circumferentially by the thin layer of proper fascia of the rectum; the pelvic sacral bone was covered with the endopelvic fascia (parietal layer of pelvic fascia). Endopelvic fascia and proper fascia of the rectum fused at the level of sacral promontory, and the presacral space is entered after the fascial junction is incised. Rectosacral fascia usually originated in the S4 level, and the retrorectal space is entered when this fascia is sharply incised. Waldeyer's fascia constitutes the fascia layer covering levator ani muscle. Denonvilliers' fascia is situated in front of proper fascia of the rectum. Usually, the anterior dissection for mobilization of the rectum is in front of Denonvilliers' fascia to ensure oncological efficacy; however, to enhance the preservation of sexual function, some surgeons suggest the dissection plane be back to the Denonvilliers' fascia. Full respect of the fascia structures is the basic principle for the precise implementation of total mesorectal excision for rectal cancer. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/431411 | ISBN: | 9789811051432 | DOI: | 10.1007/978-981-10-5143-2_4 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。