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瓦尔代尔筋膜:解剖位置及其与直肠后间隙相邻筋膜的关系

Waldeyer's fascia: anatomical location and relationship to neighboring fasciae in retrorectal space.

作者信息

Jin Zhi-ming, Peng Jia-Yuan, Zhu Qing-Chao, Yin Lu

机构信息

Department of Surgery, The Sixth People's Hospital Affiliated with Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.

出版信息

Surg Radiol Anat. 2011 Dec;33(10):851-4. doi: 10.1007/s00276-011-0887-6. Epub 2011 Oct 11.

Abstract

PURPOSE

The term Waldeyer's fascia has caused confusion in surgery for rectal cancer. We have therefore dissected endopelvic fasciae to clarify the structure and location of Waldeyer's fascia, and to determine its anatomical relationships with adjacent fasciae.

METHODS

Twenty cadavers (13 males and 7 females) were dissected. Each specimen was sectioned in the sagittal plane and both hemipelvises were examined.

RESULTS

Waldeyer's fascia was observed in all specimens originating from the presacral fascia at the S2-S4 level and fusing with the posterior leaf of the mesorectal parietal fascia. Waldeyer's fascia divided the retrorectal space (RRS) into inferior and superior compartments, with the upper leaf constituting the floor of the superior compartment and the lower leaf constituting the dome of the inferior compartment. There were no nerves, blood vessels or lymphatic vessels within the two leaves.

CONCLUSION

Waldeyer's fascia was located between the mesorectal parietal and presacral fasciae. Waldeyer's fascia included two leaves, which jointly divided the RRS into inferior and superior compartments. Waldeyer's fascia is a pivotal anatomical structure in the surgical treatment of rectal cancer.

摘要

目的

在直肠癌手术中,“瓦尔代尔筋膜”这一术语引发了混淆。因此,我们对盆腔内筋膜进行了解剖,以阐明瓦尔代尔筋膜的结构和位置,并确定其与相邻筋膜的解剖关系。

方法

解剖了20具尸体(13例男性和7例女性)。对每个标本进行矢状面切片,并检查双侧半骨盆。

结果

在所有标本中均观察到瓦尔代尔筋膜,其起自S2 - S4水平的骶前筋膜,并与直肠系膜壁层筋膜的后叶融合。瓦尔代尔筋膜将直肠后间隙(RRS)分为上、下两个腔隙,上叶构成上腔隙的底部,下叶构成下腔隙的顶部。两叶内均无神经、血管或淋巴管。

结论

瓦尔代尔筋膜位于直肠系膜壁层筋膜和骶前筋膜之间。瓦尔代尔筋膜包括两叶,共同将RRS分为上、下腔隙。瓦尔代尔筋膜是直肠癌手术治疗中的关键解剖结构。

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