The “lower pelvic space”: anatomical details and surgical relevance in gynaecological oncology

Objective: The aim of this study was to assess the anatomical space above the perineal floor, under the properitoneal pelvic tissues, while attempting to capture its details and related surgical relevance in gynaecological oncology. Materials And Methods: The authors used 12 fresh surgical specimens of female cancer patients submitted to an extralevator abdomino-perineal rectal resection, “en monobloc” with a total hysterectomy and posterior colpectomy, or a total cystectomy plus hysterectomy. They obtained as many histological macro-slides, which have been investigated with anatomo-topographic intent. Results: The authors successfully identified a small anatomical structure with a simple texture of adipose tissue, a scanty network of blood and without proper lymph nodes or nervous plexuses, wrapping the lower parts of the pelvic organs and directly continuing back and up with the retroperitoneum. Conclusion: The lower pelvic space is a real anatomic structure, with a corresponding radiological imaging. It can be affected by primary tumors of the pelvic organs, and its excision can be considered in radical pelvic surgery.

Pelvic anatomy; Retroperitoneum; Infra-mesorectum; Pelvic surgery; Gynaecological oncology

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