Alternative anterior surgical plane of total mesorectal excision for rectal cancer: partial preservation of Denonvilliers’ fascia

Zheng, Zhifang; Wang, X; Huang, Ying; Chi, Pan

doi:10.1007/s10151-021-02549-x

Cited by 1 publication

(2 citation statements)

References 5 publications

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“…This approach helps to maintain the integrity of the proper fascia of the rectum and is suitable for tumours in any circumferential location. Our previous retrospective study15–18 revealed that TME with PP-DVF was effective in protecting postoperative urogenital function with satisfactory oncological outcomes. However, there is a lack of randomised controlled trials to prove that the efficacy of TME with PP-DVF is equivalent to that with CP-DVF with respect to postoperative urogenital function.…”

Section: Introductionmentioning

confidence: 99%

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Effect of partial preservation versus complete preservation of Denonvilliers’ fascia on postoperative urogenital function in male patients with low rectal cancer (PREDICTION): protocol of a multicentre, prospective, randomised controlled clinical trial

Zheng

Wang

et al. 2022

BMJ Open

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IntroductionTotal mesorectal excision (TME) has been the gold standard for the surgical treatment of mid-low rectal cancer, but traditional TME removal of Denonvilliers’ fascia (DVF) is too low and is prone to damage the connecting branches of the bilateral neurovascular bundles, which can lead to posturogenital dysfunction. A recently published multicenter randomised controlled trial revealed that TME with complete preservation of DVF (CP-DVF) has protective effects on postoperative urogenital function for male patients with rectal cancer with specific staging and location (preoperative staging T1-4N0-2M0, but T1-2 for anterior rectal wall). Our previous studies have confirmed that TME with partial preservation of DVF (PP-DVF) could also achieve satisfactory results regardless of the circumferential location of the tumour. However, there is a lack of randomised controlled trials to prove that the efficacy of TME with PP-DVF is equivalent to that with CP-DVF with respect to postoperative urogenital function.Methods and analysisThis study is a prospective, multicentre, equivalent design, open-label randomised clinical trial in which 278 male patients with low rectal cancer will be recruited from 11 large-scale gastrointestinal medical centres in China. Patients will be randomly assigned to undergo PP-DVF or CP-DVF. We will test the hypothesis that PP-DVF is similar to CP-DVF with respect to sexual function at postoperative month 12 (5-item version of the International Erectile Function Index Questionnaire and ejaculation function classification). The secondary outcomes include the assessment of urinary function, surgical safety and oncological outcomes.Ethics and disseminationThis trial has been approved by the Institutional Review Board of Fujian Medical University Union Hospital (2020YF016-01) and is filed on record by all other centres. Written informed consent will be obtained from all eligible participants before enrolment. The trial’s results will be disseminated via peer-reviewed scientific journals and conference presentations.Trial registration numberChiCTR2000034892.

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Section: Introductionmentioning

confidence: 99%

“…Based on a better understanding of the anatomy and histology between the DVF and NVB,13 14 we have proposed dissection in front of the DVF with partial preservation (PP-DVF) 13 15–17. Briefly, the dissection commences at 1 cm above the peritoneal reflection, ensuring that the surgical plane is in front of the DVF.…”

Section: Introductionmentioning

confidence: 99%

Effect of partial preservation versus complete preservation of Denonvilliers’ fascia on postoperative urogenital function in male patients with low rectal cancer (PREDICTION): protocol of a multicentre, prospective, randomised controlled clinical trial

Zheng

Wang

et al. 2022

BMJ Open

View full text Add to dashboard Cite

show abstract

Alternative anterior surgical plane of total mesorectal excision for rectal cancer: partial preservation of Denonvilliers’ fascia

Cited by 1 publication

References 5 publications

Effect of partial preservation versus complete preservation of Denonvilliers’ fascia on postoperative urogenital function in male patients with low rectal cancer (PREDICTION): protocol of a multicentre, prospective, randomised controlled clinical trial

Effect of partial preservation versus complete preservation of Denonvilliers’ fascia on postoperative urogenital function in male patients with low rectal cancer (PREDICTION): protocol of a multicentre, prospective, randomised controlled clinical trial

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