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February 1, 2004

Pelvic Neuroanatomy and Technique of Abdominoperineal Resection of the Rectum for Cancer—Reply

Arch Surg. 2004;139(2):225. doi:10.1001/archsurg.139.2.225-b

In reply

We thank Drs Losanoff and Sauter for their comments regarding our recent article. We are aware of the importance of pelvic neuroanatomy during the abdominal portion of rectal mobilization and routinely perform meticulous pelvic nerve-sparing total mesorectal excision for the surgical treatment of rectal cancer. However, the purpose of our article was to elucidate and emphasize the equally important perineal portion of the abdominoperineal dissection, which seems to be lacking in surgical training programs. We appreciate the response by Drs Losanoff and Sauter and would emphasize to general surgery training program directors that both the perineal and pelvic anatomy should be included as part of the training in rectal cancer surgical treatment.