CAJ | 학술논문

目的明确Denonvilliers筋膜的局部解剖学特点,探讨其对于直肠癌手术的意义.方法选择30例成人骨盆标本(男17例,女13例)从正中矢状面切开并进行局部解剖,取Denonvilliers筋膜进行免疫组织化学检查. 结果所有男性标本均可以见到Denonvilliers筋膜,分前后两叶,前叶紧贴膀胱底部、精囊腺、输精管和前列腺.Denonvilliers筋膜顶部起于膀胱直肠凹腹膜返折处,向下止于盆膈的会阴筋膜,向两侧消失融合于盆壁筋膜.所有女性标本均未明确见到此筋膜,只是在阴道直肠沟内可以解剖出一层薄且透明的膜样结构.男性标本左侧骨盆Denonvilliers筋膜最大高度(3.2±0.3) cm,右侧骨盆Denonvilliers筋膜最大高度(3.3±0.3)cm,左右两侧比较差异无统计学意义(t =0.965,P＞0.05).Denonvilliers筋膜中未见淋巴结,中央部分极少有神经分布,而其两侧分布了较密集的神经.结论熟悉Denonvilliers筋膜中特殊的解剖学和病理学特点对临床直肠手术中减少神经损伤具有指导意义.
목적 명학Denonvilliers근막적국부해부학특점,탐토기대우직장암수술적의의.방법 선택30례성인골분표본(남17례,녀13례)종정중시상면절개병진행국부해부,취Denonvilliers근막진행면역조직화학검사. 결과 소유남성표본균가이견도Denonvilliers근막,분전후량협,전협긴첩방광저부、정낭선、수정관화전렬선.Denonvilliers근막정부기우방광직장요복막반절처,향하지우분격적회음근막,향량측소실융합우분벽근막.소유녀성표본균미명학견도차근막,지시재음도직장구내가이해부출일층박차투명적막양결구.남성표본좌측골분Denonvilliers근막최대고도(3.2±0.3) cm,우측골분Denonvilliers근막최대고도(3.3±0.3)cm,좌우량측비교차이무통계학의의(t =0.965,P＞0.05).Denonvilliers근막중미견림파결,중앙부분겁소유신경분포,이기량측분포료교밀집적신경.결론 숙실Denonvilliers근막중특수적해부학화병이학특점대림상직장수술중감소신경손상구유지도의의.
Objective To clarify the anatomical and pathlogical implications of Denonvilliers' fascia.Method In this study,thirty pelvic specimens (17 males and 13 females) were incised through the median sagittal plane and carried for regional anatomy study; Denonvilliers' fascia was identified by immunohistochemistry.Results Denonvilliers' fascia could be found in all male specimens:it had an anterior leaf and a posterior leaf,with the anterior one attaching to seminal vesicle,seminiferous duct,prostate and the bottom of bladder firmly.The fascia originated at the fold of the peritoneum and ended at the perineum fascia,fusing into the pelvic parietal fascia laterally.It was not obvious in females,only to find a thin and transparent membrane between vagina and rectum.The maximum height of Denonvilliers' fascia in left pelvis was (3.2 ± 0.3) cm,compared with (3.3 ± 0.3) cm in the right pelvis (t =0.965,P ＞ 0.05).Immunohistochemistry study revealed that there was no lymph node in the fascia and its lateral parts were enriched of nerve fibers,which were few in its middle part.Conclusions The unique anatomical and pathlogical characteristics of Denonvilliers' fascia are of vital importance to the avoidance of nerve injury during rectal surgery.