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What Is the Anatomical Relationship of the Nerves in the Pelvis?

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Multidisciplinary Management of Rectal Cancer

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Abstract

The pelvis is often considered to be a complex anatomical region. Due to the funnel-shaped pelvic cavity, there is a close anatomical relationship of the rectum to vital structures such as blood vessels, lymphatics and somatic and autonomic nerves. This, taken together with the relatively inaccessible location of the rectum, makes total mesorectal excision (TME) a challenging surgical procedure. The principles of TME surgery involve removal of the diseased rectum with the surrounding mesorectum as an en bloc specimen with an intact mesorectal fascia and preservation of the pelvic autonomic nerves [1]. Over the last decades, both oncological and functional outcomes of TME surgery have gained much attention. It is well known that surgical disruption of the autonomic and somatic nerves may result in postoperative urogenital and anorectal dysfunction, affecting the patient’s functional outcome [2]. If the oncological safety is not in danger, surgeons must preserve the autonomic and somatic nerves in order to warrant sufficient postoperative pelvic function.

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Authors and Affiliations

  1. Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands

    A. C. Kraima & M. C. DeRuiter

  2. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

    C. J. H. van de Velde

Authors
  1. A. C. Kraima
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  2. C. J. H. van de Velde
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  3. M. C. DeRuiter
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Corresponding author

Correspondence to M. C. DeRuiter .

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Editors and Affiliations

  1. Dept. of Radiation Oncology, UniversitĂ  Cattolica S Cuore, Rome, Italy

    Vincenzo Valentini

  2. Head, Div. Clinical Oncology Research, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

  3. Department of Surgery, Leiden Univ Med Ctr, Leiden, The Netherlands

    Cornelis J. H. van de Velde

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Kraima, A.C., van de Velde, C.J.H., DeRuiter, M.C. (2018). What Is the Anatomical Relationship of the Nerves in the Pelvis?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_47

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  • DOI: https://doi.org/10.1007/978-3-319-43217-5_47

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43215-1

  • Online ISBN: 978-3-319-43217-5

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