Abstract:

Objective    To further elucidate the fascial layer of the pelvic autonomic nerve from the view of anatomy and histology.    Methods    The relationship between autonomic nerve and prerenal fascia-presacral fascia was observed in 7 cadavers and 52 patients undergoing laparoscopic rectal cancer surgery. Histological examination was performed on the retroperitoneal tissue between mesentery of descending sigmoid colon and aortic iliac artery, and between the mesorectal and sacral periosteum.    Results   Anatomical observation showed that abdominal aortic plexus, superior hypogastric plexus, hypogastric nerve and inferior hypogastric plexus were located at the posterolateral side of the prerenal fascia-presacral fascia. Histological examination showed that the nerve fibers were located behind the fascia and some of the finer nerve fibers were located in the fascia.    Conclusion    The autonomic nerve is located in the posterolateral part of the prerenal fascia-presacral fascia. Maintaining the integrity of this fascia is the anatomical basis and basic method of preserving autonomic nerve in rectal cancer surgery.

Key words: Autonomic nerve, 　Fascia, 　Anatomy, 　Histology, 　Rectal neoplasms