Lindsey I, Guy R J, Warren B F, Mortensen N J
Departments of Colorectal Surgery and Cellular Pathology, John Radcliffe Hospital, Oxford, UK.
Br J Surg. 2000 Oct;87(10):1288-99. doi: 10.1046/j.1365-2168.2000.01542.x.
The development and anatomy of Denonvilliers' fascia have been controversial for many years and confusion exists about its operative appearance. Better appreciation of this poorly understood anatomy, and its significance for impotence after rectal dissection, may lead to further functional improvements in pelvic surgery.
A literature review of the embryology and anatomy of Denonvilliers' fascia and impotence after pelvic rectal surgery was undertaken.
Denonvilliers' fascia has no macroscopically discernible layers. The so-called posterior layer refers to the fascia propria of the rectum. The incidence of erectile and ejaculatory dysfunction after rectal excision is high in older patients, and when performed for rectal cancer. There is no consensus about the relationship of Denonvilliers' fascia to the plane of anterior dissection for rectal cancer.
Colorectal surgeons should focus on the important anatomy between the rectum and the prostate to improve functional outcomes after rectal excision. A classification of the available anterior dissection planes is proposed. Surgeons should be encouraged to document the plane used as well as outcome in terms of sexual function.
多年来，狄农维利耶筋膜的发育和解剖一直存在争议，其手术外观也存在混淆。更好地理解这一了解甚少的解剖结构及其对直肠切除术后阳痿的意义，可能会进一步改善盆腔手术的功能。
对狄农维利耶筋膜的胚胎学和解剖学以及盆腔直肠手术后阳痿的情况进行文献综述。
狄农维利耶筋膜没有肉眼可见的分层。所谓的后层是指直肠固有筋膜。老年患者行直肠癌直肠切除术后勃起功能障碍和射精功能障碍的发生率较高。关于狄农维利耶筋膜与直肠癌前方解剖平面的关系尚无共识。
结直肠外科医生应关注直肠与前列腺之间的重要解剖结构，以改善直肠切除术后的功能结局。提出了现有前方解剖平面的分类。应鼓励外科医生记录所使用的平面以及性功能方面的结果。
