Is it possible to give a single definition of the rectosigmoid junction?
- 76 Downloads
The rectosigmoid junction is the limit separating the sigmoid colon and rectum. This transition zone has different definitions. We want to highlight different landmarks of the rectosigmoid junction (RSJ), to help the clinicians to adopt a consensual definition.
We reviewed anatomical, endoscopic, physiological and surgical points of view concerning the rectosigmoid junction (RSJ).
The rectosigmoid junction has a different definition depending on who is studying it. Nevertheless, it is a high pressure location, a place connecting different muscles organizations, neurological systems or vascular anastomosis. The clear pathophysiology of the RSJ is not yet determined with certainty, but its resection is essential for the therapeutic care of patients and also for the improvement of surgical skills. From a surgical point of view, anatomical landmarks has to be chosen: easily reproducible and identifiable. The disappearance of taenia coli (belonging to the colon) and the peritoneal reflection (recto-genital pouch), located below the upper rectum, seem the most reliable. The level of rectal section must, in any case, be below the promontory.
There is not a single definition, but rather several definitions of the RSJ. Each one of them reflects one appearance of this region: embryological and anatomical evolution or clinical entity. From a surgical point of view, the criterion which seems to be the most reliable is the disappearance of taenia coli and the peritoneal reflection (recto-genital pouch).
KeywordsRectosigmoid junction Anatomy Rectum Lymph node
We thank Mr Brian Collins for his assistance in editing the article, and Mr Benjamin Maes for his drawings.
Compliance with ethical standards
Conflict of interest
We have no conflict of interest.
This study received no funding.
- 14.Couinaud C (1963). Anatomie de l’abdomen (petit bassin excepté) (Doin)Google Scholar
- 20.Junginger T, Hermanek P (2008) Problems in the treatment of upper rectal carcinoma. Chir. Z. Für Alle Geb. Oper Medizen 79:327–339Google Scholar
- 22.Käser SA, Froelicher J, Li Q, Müller S, Metzger U, Castiglione M, Laffer UT, Maurer CA (2014). Adenocarcinomas of the upper third of the rectum and the rectosigmoid junction seem to have similar prognosis as colon cancers even without radiotherapy, SAKK 40/87. Langenbecks Arch Surg 1–8Google Scholar
- 24.Massalou D, Masson C, Foti P, Afquir S, Baqué P, Berdah S-V, Bège T. Dynamic biomechanical characterization of colon tissue according to anatomical factors. J. BiomechGoogle Scholar
- 28.Raftery AT, Delbridge MS, Douglas HE (2012). Basic Science for the MRCS: a revision guide for surgical trainees (Elsevier Health Sciences)Google Scholar
- 37.Sobin LH, Gospodarowicz MK, Wittekind C (2011). TNM classification of malignant tumours. WileyGoogle Scholar
- 38.Standring S (2005) Gray’s anatomy: the anatomical basis of clinical practice. Elsevier Churchill, LivingstoneGoogle Scholar