title: Quantitative anatomical study of male pelvic autonomic plexus and its clinical potential in rectal resection.
abstract: The pelvic autonomic nerves innervate the pelvic viscera, and carry a high risk of damage during surgery. This high risk has been ascribed to the complex interrelationship of pelvic paravisceral structures and the difficulty in identifying particular structures, despite the fact that the anatomic characteristics of the pelvic autonomic plexus have been well documented. We dissected ten male embalmed adult cadavers with particular attention to the quantitative parameters of the pelvic plexus and its subsidiary plexus. The right inferior hypogastric plexus and its rectal branch were found to be significantly longer and wider than the left one, while the transverse diameter of the vesical and prostatic branches of the left side was significantly larger the right. The inferior mesenteric plexus gave off fibers directly to form the pelvic plexus in four of 20 hemipelves (20%). In the side-by-side comparison, the distance to midpoint of the sacral promontory of the left rectal plexus was significantly longer than that of the right, whereas the maximum length (the length of the longest nerve fiber from origin to corresponding organ) of the left vesical plexus was significantly shorter than that of the right. Additionally, the craniocaudal and dorsoventral diameters of the right pelvic autonomic plexus were significantly shorter those of the left. The quantitative parameters relating to the pelvic autonomic plexuses not only can enhance our understanding of its anatomy and function, but can also be used as references for surgical procedures and robot-assisted surgery.
authors.affiliation: Department of General Surgery, Shanghai Chang Zheng Hospital, Second Military Medical University, 415 Feng Yang Road, Shanghai 200003, People's Republic of China.
authors.forename: Jing-Hu
authors.initials: JH
authors.lastname: He
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.forename: Qing-Ping
authors.initials: QP
authors.lastname: Cai
authors.forename: Rui-Shan
authors.initials: RS
authors.lastname: Dang
authors.forename: Er-Peng
authors.initials: EP
authors.lastname: Jiang
authors.forename: Hui-Long
authors.initials: HL
authors.lastname: Huang
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Sun
mesh_terms: D005728:Ganglia, Sympathetic / Q000033:anatomy & histology; D006801:Humans; D007001:Hypogastric Plexus / Q000033:anatomy & histology*; D008297:Male; D010275:Parasympathetic Nervous System / Q000033:anatomy & histology; D010388:Pelvis / Q000294:innervation*; D012007:Rectum / Q000601:surgery
references.citation: Hepatogastroenterology. 2006 Nov-Dec;53(72):850-3
references.pmid: 17153439
references.citation: Ann R Coll Surg Engl. 2001 Mar;83(2):89-95
references.pmid: 11320936
references.citation: Surg Radiol Anat. 1991;13(1):17-22
references.pmid: 2053040
references.citation: Int J Clin Oncol. 2006 Oct;11(5):339-43
references.pmid: 17058130
references.citation: Hepatogastroenterology. 2007 Jan-Feb;54(73):85-90
references.pmid: 17419237
references.citation: Dis Colon Rectum. 2002 Sep;45(9):1178-85
references.pmid: 12352233
references.citation: Br J Surg. 2005 Feb;92(2):230-4
references.pmid: 15609379
references.citation: Chirurg. 2003 Feb;74(2):125-31
references.pmid: 12599030
references.citation: Yonsei Med J. 2008 Dec 31;49(6):891-6
references.pmid: 19108010
references.citation: World J Surg. 2006 Jun;30(6):1014-9
references.pmid: 16736330
references.citation: Semin Surg Oncol. 2000 Apr-May;18(3):235-43
references.pmid: 10757889
references.citation: Int J Colorectal Dis. 2006 May;21(4):308-13
references.pmid: 16059690
references.citation: World J Surg. 2007 Jun;31(6):1321-8
references.pmid: 17464540
references.citation: Dig Dis. 2007;25(1):44-50
references.pmid: 17384507
references.citation: Zhonghua Wei Chang Wai Ke Za Zhi. 2008 Jul;11(4):308-11
references.pmid: 18636348
references.citation: Eur J Surg Oncol. 2007 Nov;33(9):1068-74
references.pmid: 17524598
references.citation: J Urol. 2001 May;165(5):1652-5
references.pmid: 11342948
references.citation: World J Surg. 2008 Aug;32(8):1768-75
references.pmid: 18521663
references.citation: Dis Colon Rectum. 2003 May;46(5):621-8
references.pmid: 12792438
references.citation: Eur J Surg Oncol. 2001 Mar;27(2):165-9
references.pmid: 11289753
references.citation: Semin Surg Oncol. 2000 Dec;19(4):386-95
references.pmid: 11241921
references.citation: Surg Clin North Am. 2002 Oct;82(5):1009-18
references.pmid: 12507206
references.citation: Surg Radiol Anat. 2003 Apr;25(1):6-15
references.pmid: 12690518
references.citation: Br J Surg. 2005 Sep;92(9):1124-32
references.pmid: 15997446
references.citation: Br J Surg. 2002 Dec;89(12):1551-6
references.pmid: 12445065
references.citation: Tohoku J Exp Med. 2007 Aug;212(4):403-13
references.pmid: 17660706
references.citation: Int J Impot Res. 2006 Jan-Feb;18(1):1-18
references.pmid: 15988545
references.citation: Ann Surg Oncol. 2007 Apr;14(4):1285-7
references.pmid: 17235719
references.citation: ANZ J Surg. 2004 Apr;74(4):248-59
references.pmid: 15043737
references.citation: Acta Chir Belg. 2005 Sep-Oct;105(5):471-4
references.pmid: 16315828
references.citation: Int J Urol. 2005 Mar;12(3):256-63
references.pmid: 15828952
references.citation: J Am Coll Surg. 2004 Jan;198(1):59-66
references.pmid: 14698312
references.citation: Dis Colon Rectum. 2006 Jul;49(7):1024-32
references.pmid: 16732487
references.citation: World J Urol. 2006 Jun;24(2):136-43
references.pmid: 16758247
references.citation: Surg Endosc. 2006 Oct;20(10):1521-5
references.pmid: 16897284
references.citation: Hepatogastroenterology. 1998 Nov-Dec;45(24):2206-14
references.pmid: 9951896