MESORECTUM TARGET DELINEATION

1. MANAGEMENT OF DIFFUSE GLIOMAS
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DR KANHU CHARAN PATRO
MD,DNB (Radiation Oncology),MBA,FICRO,FAROI(USA),PDCR,CEPC
HOD(Radiation Oncology)
Mahatma Gandhi Cancer Hospital And Research Institute, Visakhapatnam
drkcpatro@gmail.com M-9160470564
TARGET DELINEATION OF MESORECTUM

2. • Mesorectum (M): The M is the fat around the
rectum, bounded by the mesorectal fascia
(MRF). In the mid-low pelvis, the M is
anteriorly bound by the MRF and by the
posterior border of the anterior pelvic organs
(prostate, seminal vesicles, bladder and penis
bulb in men and vagina and uterus in women).

3. What is Mesorectum?
• Mesorectum: The mesentery of
the rectum, i.e., mesorectum, is
the perirectal fatty lymphovascular
tissue extending the length of the
rectum.
• The mesorectum encases the
rectum as a thick cushion mainly
posteriorly and laterally.

4. What is Mesorectum?
• The mesorectum is the
perirectal fat that surrounds the
rectum.
• It is not an anatomical termed
recognized by the Terminologia
• Anatomical because it is mainly
a surgical and radiological term
for rectal cancer staging.
• It encloses the rectum and is
limited superficially by the
mesorectal fascia.

5. Mesorectum content?
• Mesorectum tissue “en
bloc” removes
lymphatic, vascular,
perineal tumor deposits.
• Positive CRM is defined
as a tumor extension
(continuous or
discontinuous) or the
presence of positive
lymph nodes <1 mm
from the radial, non
peritonealized soft
tissue border.

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7. 5.Mesorectum
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6. MRF- mesorectal fascia

9. MESORECTUM BOUNDARY
1. M: Mesorectum,
2. LLN: Lateral Lymph Nodes
3. EIN: External Iliac Nodes,
4. IN: Inguinal Nodes,
5. IRF: Ischio-Rectal Fossae,
6. SC: Sphincter Complex,
7. IMA: inferior mesenteric artery,
8. SA: sigmoid artery,
9. SRA: superior rectal arteryxx

11. Branches of IMA
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12. Inferior mesenteric artery branches
1. The branches of the
inferior mesenteric
artery include
1. Left colic, which is located
retroperitoneally and
supplies the descending
colon;
2. Sigmoid branches, which
supply the sigmoid colon;
and
3. Superior rectal artery,
which is the terminal
branch of the inferior
mesenteric artery at the
pelvic brim

13. CORONAL VIEW

14. Levator

15. IMA ORIGIN
O
R
I
G
I
N

16. Bifurcation SA and SRA
B
I
F
U
R
C
A
T
I
O
N

17. MRF

18. CORONAL

19. AXIAL
A
N
T
E
R
I
O
R

20. SAGGITAL