title: Vascular anatomy of the rectal stump after total mesorectal excision.
abstract: 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.
authors.affiliation: Department of Clinical Pathophysiology, III Section of General Surgery, University of Turin, Via Genova 3, Turin, 10126, Italy. mario.nano@unito.it
authors.forename: Mario
authors.initials: M
authors.lastname: Nano
authors.forename: Filippo
authors.initials: F
authors.lastname: Marchisio
authors.forename: Marco
authors.initials: M
authors.lastname: Ferronato
authors.forename: Andrea Doriguzzi
authors.initials: AD
authors.lastname: Breatta
authors.forename: Mario
authors.initials: M
authors.lastname: Solej
authors.forename: Stefano
authors.initials: S
authors.lastname: Barbero
authors.forename: Marcello
authors.initials: M
authors.lastname: Dei Poli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
mesh_terms: 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