ANATOMY OF THE MESORECTUM. KEY MOMENTS OF TOTAL MESORECTAL EXCISION IN ORDER TO PREVENT GENITO-URINARY COMPLICATION IN RECTAL CANCER SURGERY .

The mesorectum is the initial spreading area of the rectalcancer. The surgical important anatomical relations of the mesorectum are with the rectal vessels,the lateral rectal ligaments and the nervous plexuses of the pelvis. The total mesorectum excisionrepresents the key of local recurrence prevention after rectal resection for cancer. During surgery pelvic nerve lesions can occur after certain maneuvers: ligation of the inferior mesenteric artery,and also, the posterior, lateral and anterior dissection of the mesorectum. In this article we discuss the anatomical relations of the mesorectum. Also we analize the surgical steps during rectalresection for cancer when pelvic autonomous nerve lesions might occur.