We read with interest the recent article by Khatri et al.1 The authors emphasize the need to conceptualize the dissection on the basis of a thorough understanding of the regional anatomy that confers improved safety. We fully agree that meticulous surgical technique is mandatory to radically remove the cancer while preserving important anatomic structures such as the membranous urethra, prostate, and presacral veins, but we are disappointed that Khatri et al1 omitted the details of pelvic neuroanatomy and did not discuss autonomic nerve preservation, which is important to proper urinary and sexual function, during abdominoperineal resection of the rectum.2
Losanoff JE, Sauter ER. Pelvic Neuroanatomy and Technique of Abdominoperineal Resection of the Rectum for Cancer. Arch Surg. 2004;139(2):225. doi:10.1001/archsurg.139.2.225-a
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