The anatomy of the perineal body in relation to abdominoperineal excision for XXXX .

@entity1 @entity2362 @entity5 @entity5584 @entity982 @entity121
AIM: Dissection of the perineal body (PB) during abdominoperineal excision (APE) for @entity5 is often difficult due to lack of a natural plane of dissection. Understanding of the PB and its relation to the anorectum is essential to permit safe dissection during the perineal phase of the operation, to avoid damage to the anorectum and urogenital organs. This study describes the anatomy and histology of the PB relevant to APE. METHOD: Six @entity1 adult cadaver pelvic exenteration specimens (three males, three females) from the Leeds GIFT Research Tissue Programme were studied. @entity982 -embedded mega-blocks were produced and serially sectioned at 50 and 250  m intervals. Sections were stained by immunohistochemistry to show collagen, @entity2362 and smooth muscle. RESULTS: The PB was cylindrically-shaped in males and wedge-shaped in females. Although centrally located between the anal and urogenital triangles, it was nearly completely formed by muscle fibres derived from the @entity5584 . Thick bundles of smooth muscle mostly arising from the longitudinal muscle, inserted into the PB and @entity121 ( @entity121 ). The recto-urethralis muscle originated from the PB and separated the anterolateral PB from the urogenital organs. CONCLUSION: Smooth muscle fibres derived from the @entity5584 extend into the PB and @entity121 and appear to fix the anorectum. Dissection of the PB during APE is safe only when the smooth muscle fibres that extend into the PB are divided. This article is protected by copyright. All rights reserved.
