The Denonvilliers’fascia(DVF)plays an important role in rectal surgery because of its anatomic position and its relationship to the surrounding organs.It affects the surgical plane anterior to the rectum in the proce...The Denonvilliers’fascia(DVF)plays an important role in rectal surgery because of its anatomic position and its relationship to the surrounding organs.It affects the surgical plane anterior to the rectum in the procedure of total mesorectal excision(TME).Anatomical and embryological studies have helped us to understand this structure to some extent,but many controversies remain.In terms of its embryonical origin,there are three mainstream hypotheses:peritoneal fusion of the embryonic cul-de-sac,condensation of embryonic mesenchyme,and mechanical pressure.Regarding its architecture,the DVF may be a single,two,or multiple layers,or a composite single-layer structure.In women,most authors deem that this structure does exist but they are willing to call it the rectovaginal septum rather than the DVF.Operating behind the DVF is supported by most surgeons.This article will review those mainstreamstudies and opinions on the DVF and combine them with what we have observed during surgery to discuss those controversies and consensuses mentioned above.We hope this review may help young colorectal surgeons to have a better understanding of the DVF and provide a platform from which to guide future scientific research.展开更多
基金supported by the foundation from 1.the Shenkang Hospital Developing Center of Shanghai,ChinaThe Project of Frontier Technology in General Hospital(No.SHDC12016122)2.234 Climbing Discipline Program of first affiliated hospital of Naval Medical University(No.2019YXK032).
文摘The Denonvilliers’fascia(DVF)plays an important role in rectal surgery because of its anatomic position and its relationship to the surrounding organs.It affects the surgical plane anterior to the rectum in the procedure of total mesorectal excision(TME).Anatomical and embryological studies have helped us to understand this structure to some extent,but many controversies remain.In terms of its embryonical origin,there are three mainstream hypotheses:peritoneal fusion of the embryonic cul-de-sac,condensation of embryonic mesenchyme,and mechanical pressure.Regarding its architecture,the DVF may be a single,two,or multiple layers,or a composite single-layer structure.In women,most authors deem that this structure does exist but they are willing to call it the rectovaginal septum rather than the DVF.Operating behind the DVF is supported by most surgeons.This article will review those mainstreamstudies and opinions on the DVF and combine them with what we have observed during surgery to discuss those controversies and consensuses mentioned above.We hope this review may help young colorectal surgeons to have a better understanding of the DVF and provide a platform from which to guide future scientific research.
