Ip. Bissett et Gl. Hill, Extrafascial excision of the rectum for cancer: A technique for the avoidance of the complications of rectal mobilization, SEM SURG ON, 18(3), 2000, pp. 207-215
Serious complications can occur following mobilization of the rectum for ca
ncer including: ureteric injury, rectal perforation, hemorrhage, autonomic
nerve damage, and local recurrence of the tumor in the pelvis. Each of thes
e complications can be minimized by careful dissection in correct tissue pl
anes in the pelvis. The rectum and mesorectum are surrounded by the fascia
propria, a thin fascial envelope. This envelope offers a surface for dissec
tion that leads the surgeon to a safe plane lying inside the autonomic nerv
es, the ureter, and the presacral vessels, and lying outside of the mesorec
tum and its associated vessels and lymphatics. The surgical anatomy of the
pelvis is presented, with emphasis on the rectal fascia propria, as a basis
for a detailed description of the technique of extrafascial excision of th
e rectum. Semin. Surg, Oncol. 18:207-215, 2000, (C) 2000 Wiley-Liss, Inc.