Chen Z, Zhang XJ, Chang HD, Chen XQ, Liu SS, Wang W, Chen ZH, Ma YB, Wang L. From basic to clinical: Anatomy of Denonvilliers’ fascia and its application in laparoscopic radical resection of rectal cancer. World J Gastrointest Surg 2023; 15(10): 2108-2114 [PMID: 37969712 DOI: 10.4240/wjgs.v15.i10.2108]
Corresponding Author of This Article
Yu-Bin Ma, MCh, Full Professor, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. 1026412012@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhou Chen, Xiao-Jing Zhang, Hao-Dong Chang, Xiao-Qian Chen, Shan-Shan Liu, Yu-Bin Ma, Liang Wang, Department of Gastrointestinal Oncology Surgery, TheAffiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Wei Wang, Zhi-Heng Chen, Department of General Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Author contributions: Ma YB is the corresponding author, who proposed the title of the article, reviewed the manuscript, and funded it; Wang L revised the article; Chen Z, Chang HD and Zhang XJ completed the article, were all first authors, and contributed equally to the article; the manuscript was submitted by Chen XQ; the literature review was carried out by Chen XQ, Liu SS, Wang W and Chen ZH; all authors contributed to the article and approved the submitted version.
Supported bythe Key Project of the Qinghai Provincial Health Commission, No. 2019-wjzd-06.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Bin Ma, MCh, Full Professor, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. 1026412012@qq.com
Received: June 8, 2023 Peer-review started: June 8, 2023 First decision: July 7, 2023 Revised: July 17, 2023 Accepted: August 15, 2023 Article in press: August 15, 2023 Published online: October 27, 2023
Abstract
The total mesorectal excision (TME) approach has been established as the gold standard for the surgical treatment of middle and lower rectal cancer. This approach is widely accepted to minimize the risk of local recurrence and increase the long-term survival rate of patients undergoing surgery. However, standardized TME causes urogenital dysfunction in more than half of patients, thus lowering the quality of life of patients. Of note, pelvic autonomic nerve damage during TME is the most pivotal cause of postoperative urogenital dysfunction. The anatomy of the Denonvilliers’ fascia (DVF) and its application in surgery have been investigated both nationally and internationally. Nevertheless, controversy exists regarding the basic to clinical anatomy of DVF and its application in surgery. Currently, it is a hotspot of concern and research to improve the postoperative quality of life of patients with rectal cancer through the protection of their urinary and reproductive functions after radical resection. Herein, this study systematically describes the anatomy of DVF and its application in surgery, thus providing a reference for the selection of surgical treatment modalities and the enhancement of postoperative quality of life in patients with middle and low rectal cancer.
Core Tip: Denonvilliers’ fascia, an influential separating and barrier structure surrounding the rectum, is of paramount significance to the quality of life and the protection of pelvic autonomic nerves following surgery for rectal cancer.
