Neuro-anatomy of the perineum has gained renewed attention due to its significance in the transanal procedures for rectal cancer (eg TaTME). Surgeons embarking on this technique must have sophisticated knowledge and a precise anatomical understanding of the perineum before proceeding with this reversed rectal approach. We report anatomical observations deriving from a relevant experience in the colorectal surgery field. The collective multicenter experience of the present study is clinically relevant and based on the rectal and transanal resections performed in colorectal centers of excellence from Greece, UK, and Italy over the last 10 years (2011–2020). From the original anatomical and intraoperative observations derived from collective cases operated by this multicenter group of colorectal surgical centers in three European countries, data were retrieved and analyzed in collaboration with specialist researchers of human anatomy and interpreted for their clinical significance and potential use for preoperative planning and intraoperative guidance during TaTME. This descriptive article demonstrates in detail the neurogenic pathways encountered in the perineum and pelvic cavity during transanal procedures. Specific anatomical and topographic implications are also included serving as a guide for colorectal surgeons to perform a nerve-sparing procedure. transanal approach for rectal excision offers new insights into the complex pelvic and perineal neuroanatomy while the procedure itself remains a challenge for surgeons. Preoperative anatomical planning and 3D reconstruction may help in anticipating technical difficulties, resulting in more precise surgical dissections and decreased postoperative complications.

Re-exploring the pelvic neuroanatomy from a new perspective and a potential guidance for TaTME: a “bottom-up” approach / Christiana, Oikonomou; Stavros, Gourgiotis; Roberto, Cirocchi; Maria, Piagkou; Vasilios, Protogerou; Theodoros, Troupis; Antonio, Biondi; Pierpaolo, Sileri; Dimitrios, Filippou; Vigezzi, A.; Gallo, G.; Pata, F.; Di Marzo, F.; Angelis, N. D.; Giuliani, A.; Lezoche, G.; Guerrieri, M.; Salomone Di, Saverio. - In: UPDATES IN SURGERY. - ISSN 2038-131X. - 73:2(2021), pp. 503-512. [10.1007/s13304-020-00968-3]

Re-exploring the pelvic neuroanatomy from a new perspective and a potential guidance for TaTME: a “bottom-up” approach

Gallo G.;Pata F.
Membro del Collaboration Group
;
2021

Abstract

Neuro-anatomy of the perineum has gained renewed attention due to its significance in the transanal procedures for rectal cancer (eg TaTME). Surgeons embarking on this technique must have sophisticated knowledge and a precise anatomical understanding of the perineum before proceeding with this reversed rectal approach. We report anatomical observations deriving from a relevant experience in the colorectal surgery field. The collective multicenter experience of the present study is clinically relevant and based on the rectal and transanal resections performed in colorectal centers of excellence from Greece, UK, and Italy over the last 10 years (2011–2020). From the original anatomical and intraoperative observations derived from collective cases operated by this multicenter group of colorectal surgical centers in three European countries, data were retrieved and analyzed in collaboration with specialist researchers of human anatomy and interpreted for their clinical significance and potential use for preoperative planning and intraoperative guidance during TaTME. This descriptive article demonstrates in detail the neurogenic pathways encountered in the perineum and pelvic cavity during transanal procedures. Specific anatomical and topographic implications are also included serving as a guide for colorectal surgeons to perform a nerve-sparing procedure. transanal approach for rectal excision offers new insights into the complex pelvic and perineal neuroanatomy while the procedure itself remains a challenge for surgeons. Preoperative anatomical planning and 3D reconstruction may help in anticipating technical difficulties, resulting in more precise surgical dissections and decreased postoperative complications.
2021
coloproctology; neuroanatomy; pelvic nerves; pelvic surgery; perineum; rectal cancer; rectal surgery; rectum; TaTME; transanal surgery
01 Pubblicazione su rivista::01a Articolo in rivista
Re-exploring the pelvic neuroanatomy from a new perspective and a potential guidance for TaTME: a “bottom-up” approach / Christiana, Oikonomou; Stavros, Gourgiotis; Roberto, Cirocchi; Maria, Piagkou; Vasilios, Protogerou; Theodoros, Troupis; Antonio, Biondi; Pierpaolo, Sileri; Dimitrios, Filippou; Vigezzi, A.; Gallo, G.; Pata, F.; Di Marzo, F.; Angelis, N. D.; Giuliani, A.; Lezoche, G.; Guerrieri, M.; Salomone Di, Saverio. - In: UPDATES IN SURGERY. - ISSN 2038-131X. - 73:2(2021), pp. 503-512. [10.1007/s13304-020-00968-3]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1603292
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