Anterior plane of rectal mobilization in total mosorectal excision

Objective To clarify the appropriate anterior plane in total mesorectal excision.Methods 24 pelvises harvested from embalmed cadavers were studied by dissection in Shanghai Jiaotong University School of Medicine.Results The appearance of Denonvilliers' fascia varies considerably.Denonvilliers' fascia was more closely applied to the seminal vesicles than the rectum.Denonvilliers' fascia ends at the pelvic plexus,and in some cases,the communicating branches of bilateral pelvic plexuses run in front of Denonvilliers' fascia.Conclusion In circumstances in which the anterior circumferential margin is not threatened,the appropriate anterior plane is behind Denonvilliers' fascia for reliable preservation of autonomic nerves.