Understanding on the anatomy of the pelvic fascia and nerve structure: avoiding intraoperative nerve damage

doi:10.3969/j.issn.2095-4344.2015.33.026

Abstract

Abstract:

BACKGROUND: The pelvic nerves innervate the pelvic viscera as well as bring sensory information to the central nerve system, including splanchnic nerves and spinal nerves. Each of them comprises both motor fibers and sensitive fibers. Mostly, the key part of splanchnic plexus is pelvic plexus. Total mesorectal excision proposed by Heald in 1982 has been the “gold standard” for diagnosis and treatment of colorectal cancer. However, it carries a high risk of nerve damage during surgery, which results in urinary retention, sexual dysfunction and other complications.

OBJECTIVE: To summarize the former researches so as to get a precise understanding of the pelvic fascia and nerve structure.

METHODS: Using “splanchnic nerves, superior hypogastric plexus, pelvic plexus, pelvic splanchnic nerve, total mesorectal excision (TME), clinical anatomy” as key words, a computer-based search of PubMed was done for articles related to the pelvic nerves, including its pathway, consistent, ganglia, and reflection in pelvic viscera, published from 2000 to 2015.

RESULTS AND CONCLUSION: The main splanchnic plexus in the pelvic cavity includes superior hypogastric plexus (it is located in the triangle formed by left and right common iliac artery and the sacral promontory), and pelvic plexus (hypogastric nerve, pelvic splanchnic nerve and sacral splanchnic nerve converge at the bottom of rectum, formed pelvic plexus, also known as the inferior hypogastric plexus). It is flattened against the lateral aspect of the rectum, the dorso-lateral bladder wall and the seminal vesicles. Nerves come from the plexus contain the sympathetic nerve, parasympathetic nerve and sensory nerve. They are in charge of the motions and sensations of the pelvic organs. The definite knowledge on the anatomy of pelvic fascia and nerve structures can avoid nerve damage during operation, which can help to improve the life quality of patients.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Splanchnic Nerves, Abdomen, Pelvis

CLC Number:

R318

Zhou Le-qun, Li Wen-rui, Zhang Wei-guang. Understanding on the anatomy of the pelvic fascia and nerve structure: avoiding intraoperative nerve damage[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(33): 5389-5394.

Figures/Tables 1

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