Abstract：Objective To provide theoretical support for the correct understanding of pelvic fascia structure and surgical treatment and diagnosis for rectal cancer. Methods To search foreign references in recent years from June 1908 to June 2015, with the key words of “embryology”, “pelvic fasciae” and “mesorectum”, which are related to topography of the pelvic fasciae at Pubmed and Ovid Medline database. Results The development of the pelvic fasciae can be divided into three periods: mesenchymal period fibrous period and adipose period. After this, fasciae can be identified as a complete circle structure, the fascia propria form the inner layer, the pelvic parietal fascia and Denonvilliers′ fascia form the outer layer, similar to the circle structure in human. Conclusions The embryology of pelvic fascia study confirmed the circular distribution of pelvic fascia, provides a theoretical support for surgical treatment and diagnosis for rectal cancer.
马国龙,梁小波,王毅. 盆腔筋膜的胚胎学研究进展[J]. 中华解剖与临床杂志, 2016, 21(6): 573-575.
Ma Guolong, Liang Xiaobo, Wang Yi. Research progress on topography of the pelvic fasciae. Chinese Journal of Anatomy and Clinics, 2016, 21(6): 573-575.
Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence[J]. Br J Surg, 1982, 69(10): 613-616.
[4]
Godlewski G, Prudhomme M. Embryology and anatomy of the anorectum. Basis of surgery[J]. Surg Clin North Am, 2000, 80(1): 319-343. DOI:10.1016/S0039-6109(05)70408-4.
[5]
Aigner F, Trieb T, fner D, et al. Anatomical considerations in TNM staging and therapeutical procedures for low rectal cancer[J]. Int J Colorectal Dis, 2007, 22(11): 1339-1346. DOI:10.1007/s00384-007-0353-4.
[6]
Fritsch H. Development and organization of the pelvic connective tissue in the human fetus[J]. Ann Anat, 1993, 175(6): 531-539.
[7]
Fritsch H. Developmental changes in the retrorectal region of the human fetus[J]. Anat Embryol(Berl), 1988, 177(6): 513-522. DOI:10.1007/BF00305138.
[8]
Fritsch H, Kühnel W. Development and distribution of adipose tissue in the human pelvis[J]. Early Hum Dev, 1992, 28(1): 79-88.
[9]
Fritch H. Topography and subdivision of the pelvic connective tissue in human fetuses and in the adult[J]. Surg Radiol Anat. 1994, 16(3): 259-265.
[10]
Smith GE.Studies in the anatomy of the pelvis with special reference to the fascia and visceral supports: Part II[J]. J Anat Physiol, 1908,42( 3): 252-270.
[11]
Uhlenhuth E, Wolfe WM, Smith EM, et al.The rectogenital septum[J].Surg Gynecal Obstet ,1948, 86(2):148-163.
[12]
Milley PS, Nichols DH. A correlative investigation of the human rectovaginal septum[J]. Anat Rec, 1969, 163(3): 443-451. DOI:10.1002/ar.1091630307.
[13]
Silver PH. The role of the peritoneum in the formation of the septum recto-vesicale[J]. J Anat, 1956, 90(4): 538-546.
[14]
Ludwikowski B, Hayward IO, Fritsch H. Rectovaginal fascia: an important structure in pelvic visceral surgery? About its development, structure, and function[J]. J Pediatr Surg, 2002, 37(4): 634-638.
[15]
Takahashi T, Ueno M, Azekura K, et al. Lateral node dissection and total mesorectal excision for rectal cancer[J]. Dis Colon Rectum, 2000, 43(10 Suppl): S59-S68.
[16]
Bissett IP, Hill GL. Extrafascial excision of the rectum for cancer: a technique for the avoidance of the complications of rectal mobilization[J]. Semin Surg Oncol, 2000, 18(3): 207-215.
[17]
Kourambas J, Angus DG, Hosking P, et al. A histological study of Denonvilliers′ fascia and its relationship to the neurovascular bundle[J]. Br J Urol, 1998, 82(3): 408-410.
[18]
Costello AJ, Brooks M, Cole OJ. Anatomical studies of the neurovascular bundle and cavernosal nerves[J]. BJU Int, 2004, 94(7): 1071-1076. DOI:10.1111/j.1464-410X.2004.05106.x.
[19]
Kinugasa Y, Murakami G, Uchimoto K, et al. Operating behind Denonvilliers′ fascia for reliable preservation of urogenital autonomic nerves in total mesorectal excision: a histologic study using cadaveric specimens, including a surgical experiment using fresh cadaveric models[J]. Dis Colon Rectum, 2006, 49(7): 1024-1032. DOI:10.1007/s10350-006-0557-7.
[20]
Quirke P, Durdey P, Dixon MF, et al. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision[J]. Lancet, 1986, 2(8514): 996-999.
2016, Vol. 21 
