Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction

Abstract An understanding of the anatomy of the Denonvilliers’ fascia is essential for successful surgical outcomes for patients with rectal cancer in the mid- to lower regions, especially near the seminal vesicles and prostate in males. Whether the correct surgical plane during a total mesorectal e...

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Autores principales:	Seung Yoon Yang, Ho Seung Kim, Min Soo Cho, Nam Kyu Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/74d8581143ba47c9a57e37113e39a92f
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spelling	oai:doaj.org-article:74d8581143ba47c9a57e37113e39a92f2021-11-08T10:54:18ZThree-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction10.1038/s41598-021-01106-82045-2322https://doaj.org/article/74d8581143ba47c9a57e37113e39a92f2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01106-8https://doaj.org/toc/2045-2322Abstract An understanding of the anatomy of the Denonvilliers’ fascia is essential for successful surgical outcomes for patients with rectal cancer in the mid- to lower regions, especially near the seminal vesicles and prostate in males. Whether the correct surgical plane during a total mesorectal excision should be anterior or posterior to the Denonvilliers’ fascia is currently under debate. This study aimed to investigate the Denonvilliers’ fascia using micro-computed tomography (micro-CT) to acquire three-dimensional images nondestructively for assessments of the relationship between the Denonvilliers’ fascia, the mesorectal fascia, and neurovascular bundles to elucidate the correct anterior total mesorectal excision plane. Eight specimens were obtained bilaterally from four fresh human cadavers. Four specimens were stained with phosphotungstic acid to visualize the soft tissue, and micro-CT images were obtained; the other four specimens were stained with Masson’s trichrome to visualize connective tissue. Micro-CT images corroborate that the Denonvilliers’ fascia consists of a multilayered structure that separates the rectum from the seminal vesicles and the prostate. Specimens stained with Masson’s trichrome showed that the urogenital neurovascular bundle located at the posterolateral corner of the prostate is separated from the mesorectum by the Denonvilliers’ fascia. For the preservation of autonomic nerves necessary for urogenital function and optimal oncologic outcomes in patients with rectal cancer, a successful mesorectal excision requires a dissection plane posterior to the Denonvilliers’ fascia.Seung Yoon YangHo Seung KimMin Soo ChoNam Kyu KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Seung Yoon Yang Ho Seung Kim Min Soo Cho Nam Kyu Kim Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
description	Abstract An understanding of the anatomy of the Denonvilliers’ fascia is essential for successful surgical outcomes for patients with rectal cancer in the mid- to lower regions, especially near the seminal vesicles and prostate in males. Whether the correct surgical plane during a total mesorectal excision should be anterior or posterior to the Denonvilliers’ fascia is currently under debate. This study aimed to investigate the Denonvilliers’ fascia using micro-computed tomography (micro-CT) to acquire three-dimensional images nondestructively for assessments of the relationship between the Denonvilliers’ fascia, the mesorectal fascia, and neurovascular bundles to elucidate the correct anterior total mesorectal excision plane. Eight specimens were obtained bilaterally from four fresh human cadavers. Four specimens were stained with phosphotungstic acid to visualize the soft tissue, and micro-CT images were obtained; the other four specimens were stained with Masson’s trichrome to visualize connective tissue. Micro-CT images corroborate that the Denonvilliers’ fascia consists of a multilayered structure that separates the rectum from the seminal vesicles and the prostate. Specimens stained with Masson’s trichrome showed that the urogenital neurovascular bundle located at the posterolateral corner of the prostate is separated from the mesorectum by the Denonvilliers’ fascia. For the preservation of autonomic nerves necessary for urogenital function and optimal oncologic outcomes in patients with rectal cancer, a successful mesorectal excision requires a dissection plane posterior to the Denonvilliers’ fascia.
format	article
author	Seung Yoon Yang Ho Seung Kim Min Soo Cho Nam Kyu Kim
author_facet	Seung Yoon Yang Ho Seung Kim Min Soo Cho Nam Kyu Kim
author_sort	Seung Yoon Yang
title	Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
title_short	Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
title_full	Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
title_fullStr	Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
title_full_unstemmed	Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction
title_sort	three-dimensional anatomy of the denonvilliers’ fascia after micro-ct reconstruction
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/74d8581143ba47c9a57e37113e39a92f
work_keys_str_mv	AT seungyoonyang threedimensionalanatomyofthedenonvilliersfasciaaftermicroctreconstruction AT hoseungkim threedimensionalanatomyofthedenonvilliersfasciaaftermicroctreconstruction AT minsoocho threedimensionalanatomyofthedenonvilliersfasciaaftermicroctreconstruction AT namkyukim threedimensionalanatomyofthedenonvilliersfasciaaftermicroctreconstruction
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Three-dimensional anatomy of the Denonvilliers’ fascia after micro-CT reconstruction

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