361. an Immunohistochemical Study on Fetal Pelves Reveals Sensory-autonomic Pathways in Relation to Dissection Planes for Total Mesorectal Excision

Background: Preservation of the pelvic autonomic nerves in total mesorectal excision is of crucial importance as post-operative anorectal and urogenital dysfunction are mainly caused by surgical nerve damage. Maintenance of pelvic function requires sufficient efferent and afferent pathways. Afferent fibers include those accompanying the pudendal nerve and the autonomic nerves. The latter mediate visceral sensations such as sexual excitement, vesical and rectal distension, as well as pain sensations. Surgical preservation of these pathways might specifically contribute to improved functional outcome. The aim of this study is to reveal the afferent autonomic pathways and describe their relation with peri-rectal fascia sheaths.