Damien Massalou1,2,3, David Moszkowicz4,5, Daniela Mariage6, Patrick Baqué6,7, Olivier Camuzard7, Nicolas Bronsard7. 1. Acute Care Surgery, Chirurgie Générale d'Urgencen Universitary Hospital of Nice, Hôpital Pasteur 2, Nice Sophia-Antipolis University, 30 voie romaine, 06000, Nice, France. massalou.d@chu-nice.fr. 2. Biomechanical Applied Laboratory, UMRT24, IFSTTAR, Aix-Marseille University, Marseille, France. massalou.d@chu-nice.fr. 3. Institute of Anatomy, Medical school of Nice, Nice Sophia-Antipolis University, Nice, France. massalou.d@chu-nice.fr. 4. AP-HP, Hôpital Ambroise Paré, Service de chirurgie digestive, oncologique et métabolique, 92100, Boulogne-Billancourt, France. 5. UVSQ, Université Paris Saclay, UFR des sciences de la santé Simone Veil, 78180, Montigny-Le-Bretonneux, France. 6. Acute Care Surgery, Chirurgie Générale d'Urgencen Universitary Hospital of Nice, Hôpital Pasteur 2, Nice Sophia-Antipolis University, 30 voie romaine, 06000, Nice, France. 7. Institute of Anatomy, Medical school of Nice, Nice Sophia-Antipolis University, Nice, France.
Abstract
AIM: The rectosigmoid junction is the limit separating the sigmoid colon and rectum. This transition zone has different definitions. We want to highlight different landmarks of the rectosigmoid junction (RSJ), to help the clinicians to adopt a consensual definition. METHOD: We reviewed anatomical, endoscopic, physiological and surgical points of view concerning the rectosigmoid junction (RSJ). RESULTS: The rectosigmoid junction has a different definition depending on who is studying it. Nevertheless, it is a high pressure location, a place connecting different muscles organizations, neurological systems or vascular anastomosis. The clear pathophysiology of the RSJ is not yet determined with certainty, but its resection is essential for the therapeutic care of patients and also for the improvement of surgical skills. From a surgical point of view, anatomical landmarks has to be chosen: easily reproducible and identifiable. The disappearance of taenia coli (belonging to the colon) and the peritoneal reflection (recto-genital pouch), located below the upper rectum, seem the most reliable. The level of rectal section must, in any case, be below the promontory. CONCLUSION: There is not a single definition, but rather several definitions of the RSJ. Each one of them reflects one appearance of this region: embryological and anatomical evolution or clinical entity. From a surgical point of view, the criterion which seems to be the most reliable is the disappearance of taenia coli and the peritoneal reflection (recto-genital pouch).
AIM: The rectosigmoid junction is the limit separating the sigmoid colon and rectum. This transition zone has different definitions. We want to highlight different landmarks of the rectosigmoid junction (RSJ), to help the clinicians to adopt a consensual definition. METHOD: We reviewed anatomical, endoscopic, physiological and surgical points of view concerning the rectosigmoid junction (RSJ). RESULTS: The rectosigmoid junction has a different definition depending on who is studying it. Nevertheless, it is a high pressure location, a place connecting different muscles organizations, neurological systems or vascular anastomosis. The clear pathophysiology of the RSJ is not yet determined with certainty, but its resection is essential for the therapeutic care of patients and also for the improvement of surgical skills. From a surgical point of view, anatomical landmarks has to be chosen: easily reproducible and identifiable. The disappearance of taenia coli (belonging to the colon) and the peritoneal reflection (recto-genital pouch), located below the upper rectum, seem the most reliable. The level of rectal section must, in any case, be below the promontory. CONCLUSION: There is not a single definition, but rather several definitions of the RSJ. Each one of them reflects one appearance of this region: embryological and anatomical evolution or clinical entity. From a surgical point of view, the criterion which seems to be the most reliable is the disappearance of taenia coli and the peritoneal reflection (recto-genital pouch).
Authors: S A Käser; J Froelicher; Q Li; S Müller; U Metzger; M Castiglione; U T Laffer; C A Maurer Journal: Langenbecks Arch Surg Date: 2014-08-28 Impact factor: 3.445
Authors: Thomas A Hope; Marc J Gollub; Supreeta Arya; David D B Bates; Dhakshinamoorthy Ganeshan; Mukesh Harisinghani; Kartik S Jhaveri; Zahra Kassam; David H Kim; Elena Korngold; Neeraj Lalwani; Courtney C Moreno; Stephanie Nougaret; Viktoriya Paroder; Raj M Paspulati; Jennifer S Golia Pernicka; Iva Petkovska; Perry J Pickhardt; Gaiane M Rauch; Michael H Rosenthal; Shannon P Sheedy; Natally Horvat Journal: Abdom Radiol (NY) Date: 2019-11