Quantitative anatomical study of male pelvic autonomic plexus and its clinical potential in rectal resection |
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Authors: | Jing-Hu He Qiang Wang Qing-Ping Cai Rui-Shan Dang Er-Peng Jiang Hui-Long Huang Yan-Ping Sun |
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Institution: | (1) Department of General Surgery, Shanghai Chang Zheng Hospital, Second Military Medical University, 415 Feng Yang Road, Shanghai, 200003, People’s Republic of China;(2) Department of Human Anatomy, Second Military Medical University, Shanghai, People’s Republic of China; |
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Abstract: | The pelvic autonomic nerves innervate the pelvic viscera, and carry a high risk of damage during surgery. This high risk has
been ascribed to the complex interrelationship of pelvic paravisceral structures and the difficulty in identifying particular
structures, despite the fact that the anatomic characteristics of the pelvic autonomic plexus have been well documented. We
dissected ten male embalmed adult cadavers with particular attention to the quantitative parameters of the pelvic plexus and
its subsidiary plexus. The right inferior hypogastric plexus and its rectal branch were found to be significantly longer and
wider than the left one, while the transverse diameter of the vesical and prostatic branches of the left side was significantly
larger the right. The inferior mesenteric plexus gave off fibers directly to form the pelvic plexus in four of 20 hemipelves
(20%). In the side-by-side comparison, the distance to midpoint of the sacral promontory of the left rectal plexus was significantly
longer than that of the right, whereas the maximum length (the length of the longest nerve fiber from origin to corresponding
organ) of the left vesical plexus was significantly shorter than that of the right. Additionally, the craniocaudal and dorsoventral
diameters of the right pelvic autonomic plexus were significantly shorter those of the left. The quantitative parameters relating
to the pelvic autonomic plexuses not only can enhance our understanding of its anatomy and function, but can also be used
as references for surgical procedures and robot-assisted surgery. |
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