Waldeyer's fascia: anatomical location and relationship to neighboring fasciae in retrorectal space

Abstract

Purpose: The term Waldeyer's fascia has caused confusion in surgery for rectal cancer. We have therefore dissected endopelvic fasciae to clarify the structure and location of Waldeyer's fascia, and to determine its anatomical relationships with adjacent fasciae.

Methods: Twenty cadavers (13 males and 7 females) were dissected. Each specimen was sectioned in the sagittal plane and both hemipelvises were examined.

Results: Waldeyer's fascia was observed in all specimens originating from the presacral fascia at the S2-S4 level and fusing with the posterior leaf of the mesorectal parietal fascia. Waldeyer's fascia divided the retrorectal space (RRS) into inferior and superior compartments, with the upper leaf constituting the floor of the superior compartment and the lower leaf constituting the dome of the inferior compartment. There were no nerves, blood vessels or lymphatic vessels within the two leaves.

Conclusion: Waldeyer's fascia was located between the mesorectal parietal and presacral fasciae. Waldeyer's fascia included two leaves, which jointly divided the RRS into inferior and superior compartments. Waldeyer's fascia is a pivotal anatomical structure in the surgical treatment of rectal cancer.