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Whether the correct surgical plane during a total mesorectal excision should be anterior or posterior to the Denonvilliers\u2019 fascia is currently under debate. This study aimed to investigate the Denonvilliers\u2019 fascia using micro-computed tomography (micro-CT) to acquire three-dimensional images nondestructively for assessments of the relationship between the Denonvilliers\u2019 fascia, the mesorectal fascia, and neurovascular bundles to elucidate the correct anterior total mesorectal excision plane. Eight specimens were obtained bilaterally from four fresh human cadavers. Four specimens were stained with phosphotungstic acid to visualize the soft tissue, and micro-CT images were obtained; the other four specimens were stained with Masson\u2019s trichrome to visualize connective tissue. Micro-CT images corroborate that the Denonvilliers\u2019 fascia consists of a multilayered structure that separates the rectum from the seminal vesicles and the prostate. Specimens stained with Masson\u2019s trichrome showed that the urogenital neurovascular bundle located at the posterolateral corner of the prostate is separated from the mesorectum by the Denonvilliers\u2019 fascia. For the preservation of autonomic nerves necessary for urogenital function and optimal oncologic outcomes in patients with rectal cancer, a successful mesorectal excision requires a dissection plane posterior to the Denonvilliers\u2019 fascia.<\/jats:p>","DOI":"10.1038\/s41598-021-01106-8","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T07:06:21Z","timestamp":1636095981000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Three-dimensional anatomy of the Denonvilliers\u2019 fascia after micro-CT reconstruction"],"prefix":"10.1038","volume":"11","author":[{"given":"Seung Yoon","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Seung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Soo","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Kyu","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"1106_CR1","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1007\/s10350-006-0557-7","volume":"49","author":"Y Kinugasa","year":"2006","unstructured":"Kinugasa, Y. et al. Operating behind Denonvilliers\u2019 fascia for reliable preservation of urogenital autonomic nerves in total mesorectal excision: a histologic study using cadaveric specimens, including a surgical experiment using fresh cadaveric models. Dis. Colon Rectum 49, 1024\u20131032. https:\/\/doi.org\/10.1007\/s10350-006-0557-7 (2006).","journal-title":"Dis. Colon Rectum"},{"key":"1106_CR2","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1046\/j.1365-2168.2000.01542.x","volume":"87","author":"I Lindsey","year":"2000","unstructured":"Lindsey, I., Guy, R. J., Warren, B. F. & Mortensen, N. J. Anatomy of Denonvilliers\u2019 fascia and pelvic nerves, impotence, and implications for the colorectal surgeon. Br. J. Surg. 87, 1288\u20131299. https:\/\/doi.org\/10.1046\/j.1365-2168.2000.01542.x (2000).","journal-title":"Br. J. 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