Abstract
Background: Preservation of the pelvic autonomic nerves in total mesorectal excision (TME) is of crucial importance as post-operative anorectal and urogenital dysfunction are mainly caused by surgical nerve damage. Maintenance of pelvic function requires combined action of the sympathetic and parasympathetic nervous system. The importance of preserving the inferior hypogastric plexus, a mixed sympathetic and parasympathetic plexus, has been frequently emphasized. The superior hypogastric plexus (SHP), located ventrally to the abdominal aorta and its bifurcation, is also likely to be surgically damaged during TME.
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