Anatomy of the Mesentery

Area of Science:

• Surgical Oncology
• Anatomy
• Colorectal Surgery

Background:

• Surgery is the primary treatment for colorectal cancer.
• Anatomical understanding, specifically fascial and mesenteric planes, is vital for effective surgical intervention.
• Pioneering work in total mesorectal excision (TME) and mesocolic excision has advanced cancer surgery principles.

Purpose of the Study:

• To outline the historical development of understanding mesenteric anatomy in cancer surgery.
• To emphasize the importance of mesenteric anatomy for oncological surgical outcomes.
• To highlight the foundational role of mesenteric anatomy in colorectal cancer management.

Main Methods:

• Review of historical advancements in understanding mesenteric anatomy.
• Discussion of embryological principles guiding surgical dissection.
• Analysis of surgical outcomes related to mesenteric plane adherence versus breaching.

Main Results:

• Mesenteric-based surgery, like TME and mesocolic excision, is associated with superior outcomes in colorectal cancer.
• Adherence to embryological planes during dissection enhances the oncological surgical envelope.
• Breaching the mesenteric plane often leads to suboptimal surgical results.

Conclusions:

• A thorough understanding of mesenteric anatomy is the scientific basis for successful colorectal cancer surgery.
• Mesenteric-based excision remains the gold standard for maximizing oncological outcomes in colorectal cancer.
• Continued appreciation of mesenteric anatomy is essential for advancing the art of cancer surgery.