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目的探讨直肠全系膜切除术前方合理的切除平面。方法上海交通大学医学院附属瑞金医院对24具尸体的盆腔进行解剖。结果Denonvilliers筋膜的厚度变化明显,其与精囊的结合比与直肠的结合更为紧密。Denonvilliers筋膜的两侧与盆丛相邻,在5(5/12)具男性尸体中,Denonvilliers筋膜前方有两侧盆丛的交通支。结论对于非直肠前方的肿瘤,可以采取Denonvilliers筋膜后方的切除平面,以减少自主神经功能损伤。
Objective To explore the reasonable resection plane of the total mesorectal excision. Methods The pelvis of 24 corpses was dissected in Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine. Results The thickness of Denonvilliers’ fascia changed significantly, and its binding to the seminal vesicle was more intense than that to the rectum. On both sides of the Denonvilliers fascia, adjacent to the basin, in 5 (5/12) male bodies, there are traffic branches on both sides of the Denonvilliers fascia. Conclusions For tumors in front of the rectum, a resection plane behind the Denonvilliers fascia can be used to reduce autonomic nerve dysfunction.