摘要
目的了解盆腔自主神经的解剖 ,减少直肠癌手术中对自主神经的损伤。方法通过解剖 7例尸体了解盆腔自主神经的分布 ,并于 10例直肠癌手术中进一步验证。结果上腹下丛紧贴肠系膜下血管的后方 ;直肠正后方的脏层筋膜与壁层筋膜之间的疏松间隙内无明显自主神经分支 ;直肠与精囊和前列腺 (或子宫、阴道 )之间无明显的神经支 ;盆丛呈网状不规则四边形结构 ,其四个角不在同一平面。直肠侧韧带主要由盆丛发至直肠的分支及结缔组织构成。结论当实施保留自主神经的直肠癌根治术时 ,肠系膜下血管可作为寻找上腹下丛的标志 ;游离直肠时应先游离其后壁及前壁 ,后游离其侧方 ,使直肠侧韧带呈桥状架于直肠与盆丛之间 ;侧方的游离应于盆丛的内侧 。
Objective To study the anatomy of pelvic autonomic nerves, to avoid autonomic nerves damage during rectal cancer surgery. MethodsAnatomical dissections were carried out on 7 adult cadavers, and clinically autonomic nerve-preserving rectal cancer resection was performed. Results The superior hypogastric plexus lies just posterior to the inferior mesenteric vessels. There were no obvious autonomic nerve trunks in the loose areolar tissue plane between the parietal fascia and the visceral fascia right posterior to the rectum. There were no obvious autonomic nerve trunks between the rectum and the seminal vesicles or the prostate. The inferior hypogastric plexus was a rhomboid shaped plaque of nervous tissue. The main components of the lateral ligament were autonomic nerves passing from the pelvic plexus to the rectum within a condensation of connective tissue. WT5”HZConclusionsThe inferior mesenteric vessels can be used a landmark intraoperatively to identify the superior hypogastric plexus. In order to preserve the inferior hypogastric plexus while dissecting the lateral of rectum, we should dissect along the medial surface of the inferior hypogastric plexus, and along its curvature. JP2
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第10期597-598,共2页
Chinese Journal of General Surgery
关键词
盆腔自主神经
解剖学
直肠癌
手术治疗
自主神经保留
Autonomic pathways
KG1Colorectal neoplasms
Anatomy
KG1Surgical procedures,operativeJPHJHK
