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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 3/2016

01-03-2016 | Original Article

Morphological study of the neurovascular bundle to elucidate nerve damage in pelvic surgery

Authors: Mitsutaka Nishimura, Yuji Nishizawa, Munekazu Naito, Shuichi Hirai, Masahiro Itoh, Masaaki Ito, Shintaro Akamoto, Yasuyuki Suzuki

Published in: International Journal of Colorectal Disease | Issue 3/2016

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Abstract

Purpose

Postoperative sexual and urinary dysfunction may occur after rectal cancer surgery involving the pelvis, but this problem cannot be solved. The aim of this study was to examine the nerve morphology of the neurovascular bundle in cadavers to determine possible causes of nerve damage during surgery.

Methods

Twenty-two formalin-fixed cadavers were used in the study. The cadavers were donated to the Tokyo Medical University. The study comprised histological evaluation of paraffin-embedded bilateral neurovascular bundle specimens from the cadavers. Four slides of 3-cm thick were made every 1 cm in a plane perpendicular to the rectum towards the pelvic floor from the peritoneal reflection in bilateral neurovascular bundles in 22 cadavers. The number of nerves, the mean nerve area, and the mean nerve diameter were measured in each slide.

Results

The results were categorized into cases with high (group H) and low (group L) positions of the pelvis 1 cm above and 2 cm below the peritoneal reflection, respectively. There was no significant difference in the number of nerves between these groups. The nerve area and nerve diameter were significantly smaller in group L, and these characteristics were more marked in males.

Conclusions

Our results show that the nerves of the neurovascular bundle became smaller in the deep pelvis. This may cause these nerves to be more susceptible to injury, resulting in nerve damage in the deep pelvis that leads to postoperative dysfunction. Particularly, this type of nerve damage may be a cause of postoperative sexual dysfunction in males.
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Metadata
Title
Morphological study of the neurovascular bundle to elucidate nerve damage in pelvic surgery
Authors
Mitsutaka Nishimura
Yuji Nishizawa
Munekazu Naito
Shuichi Hirai
Masahiro Itoh
Masaaki Ito
Shintaro Akamoto
Yasuyuki Suzuki
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 3/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2470-9

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