Rectal Cancer
Rectum and the Anal Duct
Length = 12-15 cm
Superior Limit
•Represented by the recto sigmoidian junction
•National Cancer Institute -12 cm from the anocutaneous line
•> 12 cm like the colon cancer
•<12 cm like the medium or inferior cancer
•By surgical circumferential mobilisation, the rectum obtains 5 more cm.
•A 7 cm lesion arrives at 12cm
The surgical anal duct
•TilL the anorectal junction
•4 cm length
Superior:
-11-15 cm; the peritoneum covers both parts
Medium:
-7-11 cm;the peritoneum covers the anterior part
Inferior:
-0-7 cm; totally extraperitoneal
1
, Rectal Vascularisation
Mezorectum
Content
• Branches of the superior rectal artery
•Veins-branches of the rectal superior vein
•Lymph vessels and lymph nodes situated around the superior rectal artery
•Fat tissue who contains all these elements
Rectal trauma
•Rectum –more frequently affected by:
–Shooting
–Fall with perianal region on a sharp object
–Crushing of the pelvis with associated bladder, ureter, prostate, urethral injuries
–Iatrogenic injuries(during barium enema, rectal biopsy, colonoscopy, genital or urologic
surgery)
2
Rectum and the Anal Duct
Length = 12-15 cm
Superior Limit
•Represented by the recto sigmoidian junction
•National Cancer Institute -12 cm from the anocutaneous line
•> 12 cm like the colon cancer
•<12 cm like the medium or inferior cancer
•By surgical circumferential mobilisation, the rectum obtains 5 more cm.
•A 7 cm lesion arrives at 12cm
The surgical anal duct
•TilL the anorectal junction
•4 cm length
Superior:
-11-15 cm; the peritoneum covers both parts
Medium:
-7-11 cm;the peritoneum covers the anterior part
Inferior:
-0-7 cm; totally extraperitoneal
1
, Rectal Vascularisation
Mezorectum
Content
• Branches of the superior rectal artery
•Veins-branches of the rectal superior vein
•Lymph vessels and lymph nodes situated around the superior rectal artery
•Fat tissue who contains all these elements
Rectal trauma
•Rectum –more frequently affected by:
–Shooting
–Fall with perianal region on a sharp object
–Crushing of the pelvis with associated bladder, ureter, prostate, urethral injuries
–Iatrogenic injuries(during barium enema, rectal biopsy, colonoscopy, genital or urologic
surgery)
2
