The “Y”-shaped Denonvilliers’ fascia and its adjacent relationship with the urogenital fascia based on a male cadaveric anatomical study

BMC Surgery

Research

Ya-Min Zhao¹  Jin-Song Zhou²  Yan-Bing Ma²  Li-Kun Yan³  Yi Li³  Cong Tong³ 

[1] Department of General Surgery, Shandong Provincial Linyi Jinluo Hospital, 276036, Linyi, Shandong, China;Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, 710061, Xi’an, Shaanxi, China;First Department of General Surgery, Shaanxi Provincial People’s Hospital, 710068, Xi’an, Shaanxi, China;

关键词: Denonvilliers’ fascia;    Urogenital fascia;    Fascia propria of the rectum;    Prerectal space;   

DOI  :  10.1186/s12893-023-01913-y

 received in 2022-05-25, accepted in 2023-01-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundControversies regarding the anatomical structure of Denonvilliers’ fascia and its relationship with surrounding fasciae have sparked a heated discussion, especially concerning whether Denonvilliers’ fascia is multilayered. This study aimed to expound on the anatomical structure of Denonvilliers’ fascia and its correlation with the peritoneum from the sagittal view and clarify the complex fascial relationship.MethodsOur study was performed on 20 adult male pelvic specimens fixed in formalin, including 2 entire pelvic specimens and 18 semipelvic specimens. The local adjacent organs and fasciae were dissected, and Denonvilliers’ fascia was observed and removed for histological examination.ResultsDenonvilliers’ fascia was typically single-layered and tough. On the sagittal plane, the peritoneum constituting the peritoneal reflection and Denonvilliers’ fascia formed a “Y” shape. Denonvilliers’ fascia originated from the peritoneal reflection, extended along the ventral side of the seminal vesicles and prostate, continuing caudally; its bilateral sides closely connected to the urogenital fascia (UGF) of the pelvic wall. In addition, histology preliminarily indicated that the basal cell layers of the peritoneum and Denonvilliers’ fascia were continuous and formed a “Y” shape. Furthermore, the basal cells of the two peritonea extended to Denonvilliers’ fascia, creating a fused double-layered structure. Some tiny blood vessels or a network of such vessels extended from the peritoneum to Denonvilliers’ fascia.ConclusionDenonvilliers’ fascia, the extension of the peritoneum in the pelvic floor, appears as a single-layered “Y”-shape on the sagittal plane. Our study provides new support for the peritoneal fusion theory. Understanding the anatomical characteristics of Denonvilliers’ fascia and its relationship with the UGF is of guiding significance for inexperienced colorectal surgeons to conduct rectal cancer surgery.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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