Vascular anatomy of the rectal stump after total mesorectal excision.
OBJECTIVE
For many years, poor vascularization of the short rectal stump has been considered the main cause of leakage. The purpose of this study was to evaluate the vascularization of the rectal stump after total mesorectal excision.


METHODS
We studied the iliac vascularization on 28 volunteers with healthy rectum to have an anatomic basis. Then, we studied the vascularization of the rectal stumps after total mesorectal excision by using angio computed tomography at seven and three months after operating on 22 patients; we validated this technique by studying the vascularization using angio computed tomography in 18 rectal specimens from cadavers.


RESULTS
Both in healthy rectums and in rectal stumps after total mesorectal excision, there is good vascularization sustained by middle and inferior rectal arteries. The former is more important and frequent as described in previous literature.


CONCLUSIONS
The vascularization of the short rectal stump is generally well represented even after total mesorectal excision.
Nano
Mario
M
Department of Clinical Pathophysiology, III Section of General Surgery, University of Turin, Via Genova 3, Turin, 10126, Italy. mario.nano@unito.it
Marchisio
Filippo
F
Ferronato
Marco
M
Breatta
Andrea Doriguzzi
AD
Solej
Mario
M
Barbero
Stefano
S
Dei Poli
Marcello
M
Gandini
Giovanni
G
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002102:Cadaver; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed