IngentaConnect Review of the anatomic concepts in relation to the retrorectal sp...

Authors: García-Armengol, J.¹; García-Botello, S.²; Martinez-Soriano, F.³; Roig, J. V.¹; Lledó, S.²

Source: Colorectal Disease, Volume 10, Number 3, March 2008 , pp. 298-302(5)

Abstract:

Objective

A precise anatomical study of the fascias within the retrorectal space is reported, analyzing and clarifying the anatomical concepts previously employed to describe Waldeyer's and the rectosacral fascia. Method

The pelvis was dissected in 15 cadavers (10 males and five females). All specimens were divided in the median sagittal plane including the middle axis of the anal canal, to allow a correct visualization of and access to the retrorectal space. Results

The retrorectal space was limited anteriorly by the rectum and posterior mesorectum covered by a fine visceral fascia, and posteriorly by the sacrum covered by the parietal presacral fascia. The rectosacral fascia divided the retrorectal space into inferior and superior portions in 80% of the male and 100% of the female specimens. It originated from the presacral parietal fascia at the level of S2 in 15%, S3 in 38% and S4 in 46% of specimens. In all cases it passed caudally to join the rectal visceral fascia 3-5 cm above the anorectal junction. As described by Waldeyer, the floor of the retrorectal space is formed by the fusion of the presacral parietal fascia and the rectal visceral fascia and lies above the levator ani muscle at the level of the anorectal junction. Conclusion

The rectosacral fascia divides the retrorectal space into inferior and superior portions. This must be differentiated from Waldeyer's description of the fascia lying in the inferior limit of the retrorectal space, formed by the fusion of the rectal visceral and parietal fascias.

Keywords: Retrorectal space; endopelvic fascia; presacral parietal fascia; rectal visceral fascia; rectosacral fascia; Waldeyer's fascia

Document Type: Research article

DOI: 10.1111/j.1463-1318.2007.01472.x

Affiliations: 1: Coloproctology Unit, Department of Surgery, Consorcio Hospital General Universitario of Valencia 2: Coloproctology Unit, Department of Surgery, Hospital Clínico Universitario of Valencia 3: Department of Morfologic Sciences, University of Valencia, Valencia, Spain

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Review of the anatomic concepts in relation to the retrorectal space and endopelvic fascia: Waldeyer's fascia and the rectosacral fascia