Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.27
Peer-review started: September 18, 2014
First decision: October 16, 2014
Revised: December 10, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 28, 2015
Core tip: Radical resection of rectal cancer entails removal of the rectum with its fascia as an intact unit while preserving surrounding vital structures. The procedure is technically challenging because of the complex multilayered pelvic fascia and intimate relationship between the rectum and vital surrounding structures. Despite the clear-cut “text book” description of surgical technique and straightforward manner of handling different structures in the pelvis, there are many variations and contradictory accounts reported in the literature as to the nature, anatomy and significance of some of the structures, proper plane of dissection, and the optimal technique to achieve oncological resection while decreasing urogenital and bowel dysfunction.