直肠膀胱(子宫)襞在直肠癌手术中预防盆段输尿管损伤的临床意义

Clinical significance of rectovesical/rectouterine folds to prevent pelvic ureteral injury during operation of rectal carcinoma

目的结合直肠膀胱(子宫)襞的解剖特点,探讨其在直肠癌手术中预防盆段输尿管损伤的临床意义。方法自2005年1月至2011年1月对56例直肠癌手术中直肠膀胱(子宫)襞的解剖位置及其与盆段输尿管、直肠系膜的毗邻关系进行仔细观察,全直肠系膜切除保持沿直肠膀胱(子宫)襞内侧界面进行。结果全组均未发生盆段输尿管损伤,术中均可清楚观察到直肠膀胱(子宫)襞这一解剖结构,其位置较为恒定并位于盆段输尿管、直肠系膜之间。结论以直肠膀胱(子宫)襞作为解剖标识,在直肠癌手术中预防盆段输尿管损伤具有一定的临床意义。

Objective To evaluate clinical significance of rectovesical/rectouterine folds to prevent pelvic ureteral injury during the operation of rectal carcinoma with respect to its anatomic characteristics.Methods The anatomic location of rectovesical/rectouterine folds and their relationships with the pelvic ureter and mesorectum were carefully observed in all the 56 cases studied from January 2005 to January 2011.Total mesorectal excision was performed consistently inside the rectovesical/rectouterine folds.Results No pelvic ureteral injury occurred in all cases.The anatomic structures of rectovesical/rectouterine folds could be clearly identified in all the 56 cases of rectal carcinoma operation studied.Their location between the pelvic ureter and mesorectum was comparatively constant.Conclusions Rectovesical /rectouterine folds can be used as an anatomic landmark to prevent pelvic ureteral injury during the operation of rectal carcinoma.