The parasympathetic supply to the distal colon-one marker for precisely locating the posterior dissection plane in the operation of TME.
BACKGROUND
It is important for surgeons to locate the reliable surgical planes in the operation of total mesorectal excision (TME); we observe the parasympathetic nerve to the distal colon can be served as one of useful markers for precisely locating the posterior dissection plane in TME.


METHODS
From October 2006 to January 2008, 26 patients underwent TME for rectal cancer. The dissections of the parasympathetic nerves to the distal colon were performed and the relationship of these nerves to the prehypogastric nerve fascia was observed.


RESULTS
Some parasympathetic nerves ran upwards and lay anteromedial to the hypogastric nerves. In the avascular space between prehypogastric nerve fascia and the fascia propria of the rectum, the prehypogastric nerve fascia enveloped parasymphathetic nerve up to the fascia propria of rectum.


CONCLUSIONS
The parasympathetic nerve to the distal colon is evident between the fascia propria of the rectum and the prehypogastric nerve fascia. As the precise dissection plane of TME lay between the fascia propria of the rectum and the prehypogastric nerve fascia, these nerves could be served as useful marker for precisely locating the posterior dissection plane in TME.
Bi
Dong-song
DS
Department of General Surgery, Qilu hospital, Shandong University, Jinan, China. chxj0513@sina.com
Li
Tao
T
Wang
Ke-Xin
KX
Gao
Hai-Dong
HD
San-Yuan
HuSan-Yuan
HY
D000328:Adult; D000368:Aged; D003106:Colon / Q000294:innervation*; D005260:Female; D006652:Histological Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000033:anatomy & histology*; D012007:Rectum / Q000601:surgery*