The fascial structures of the rectum and the “so-called mesorectum”: an anatomical or a terminological controversy?

Abstract

Since the introduction of Total Mesorectal Excision (TME), the term mesorectum has been largely used by surgeons to indicate the perirectal adipose tissue contained within the rectal fascia [3]. From a scientiWcally correct anatomical point of view the use of the term mesorectum should be discouraged. It is a misnomer which has caused lack of clarity and misleading in literature since numerous authors frequently reported the concept that the rectum presents a proper mesorectum. The preWx meso- indicates a peritoneal fold linking a segment of the digestive tube to the wall and containing vessels and nerves; according to this deWnition, the rectum does not have a true “meso”. The rectum is a retroperitoneal organ covered by peritoneum on two-thirds of its anterolateral surfaces. Posteriorly, the rectum lacks any peritoneal folds. Moreover, its walls are encircled by fat tissue