Total Mesorectum Excision Anatomical Study And Clinical Application Of Ureter In Protection

Objective:To explore the anatomy and protection method of the left side urethra in Total Mesorectal Excision (TME), in order to provide anatomy evidence for urethra Protection.Methods:The specimen of40cases of human corpse10%postvaccination, using the total mesorectal excision (TME),dissected the path and the surrounding adjacent structures of ureter, Measurement of diatance between abdominal aortic bifurcation with the sacral promontory and the inferior mesenteric artery root, measuring the distance of the left ureter across the iliac artery to the abdominal aortic bifurcation, and the inner mouth.To use the relationship between abdominal aortic and the left ureter to locate and reveal the left ureter during the clinical operation,observe the disk of damaging the left ureter and the time of revealing the left ureter.Result:The left ureter ran medially and was close to the left mesocolon. The distance of the left ureter across the iliac artery to the abdominal aortic bifurcation:5.35±1.12cm, The distance of the left ureter across the iliac artery to the inner mouth:8.93±0.86cm,The diatance between abdominal aortic bifurcation with the inferior mesenteric artery root:5.83±0.43cm,The diatance between abdominal aortic bifurcation with the sacral promontory:5.63±1.16cm.The left ureter across the common iliac artery is located roughly1/3of the abdominal aortic bifurcation to the left inner mouth. The left ureter of the basin behind presacral fascia of basin sidewall,away from direct mesenteric, and is located in the anterolateral of the rectum lateral ligament. Mesorectum is located in front of the presacral fascia, have the different anatomical spaces beween the ureter.It is uesful to to locate and reveal the left ureter during the clinical operation by the anatomy landmarks.Conclusions:During Total Mesorectal Excision (TME), to master the correct anatomical plane, using of the anatomic landmarks of the sacral promontory, the iliac vessels, internal ring, the abdominal aortic bifurcation to revealed the accurate positioning of ureter, and according to the track of the ureter,to protection and avoid injury of.