Essential anatomy of the anorectum for colorectal surgeons focused on the gross anatomy and histologic findings

Jong Min Lee, Nam Kyu Kim

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle is connected directly to the conjoined longitudinal muscle at the top of the external anal sphincter. Preserving the rectourethralis muscle without damage to the carvernous nerve or veins passing through it when the abdominoperineal resection is implemented is important. The mesorectal fascia is a multi-layered membrane that surrounds the mesorectum. Because the autonomic nerves also pass between the mesorectal fascia and the parietal fascia, a sharp pelvic dissection must be made along the anatomic fascial plane. With the development of pelvic structure anatomy, we can understand better how we can remove the tumor and the surrounding metastatic lymph nodes without damaging the neural structure. However, because the anorectal anatomy is not yet fully understood, we hope that additional studies of anatomy will enable anorectal surgery to be performed based on complete anatomical knowledge.

Original languageEnglish
Pages (from-to)59-71
Number of pages13
JournalAnnals of Coloproctology
Volume34
Issue number2
DOIs
Publication statusPublished - 2018 Apr

Fingerprint

Anatomy
Muscles
Fascia
Anal Canal
Autonomic Pathways
Rectum
Smooth Muscle
Surgeons
Dissection
Veins
Lymph Nodes
Membranes
Neoplasms

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

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abstract = "The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle is connected directly to the conjoined longitudinal muscle at the top of the external anal sphincter. Preserving the rectourethralis muscle without damage to the carvernous nerve or veins passing through it when the abdominoperineal resection is implemented is important. The mesorectal fascia is a multi-layered membrane that surrounds the mesorectum. Because the autonomic nerves also pass between the mesorectal fascia and the parietal fascia, a sharp pelvic dissection must be made along the anatomic fascial plane. With the development of pelvic structure anatomy, we can understand better how we can remove the tumor and the surrounding metastatic lymph nodes without damaging the neural structure. However, because the anorectal anatomy is not yet fully understood, we hope that additional studies of anatomy will enable anorectal surgery to be performed based on complete anatomical knowledge.",
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Essential anatomy of the anorectum for colorectal surgeons focused on the gross anatomy and histologic findings. / Lee, Jong Min; Kim, Nam Kyu.

In: Annals of Coloproctology, Vol. 34, No. 2, 04.2018, p. 59-71.

Research output: Contribution to journalReview article

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