[The surgical anatomy of the rectal and anal blood vessels].

The authors examined 40 rectum specimens by angiography, preparation and staining methods to show the exact arterial vessel supply of the rectum and tried to find out whether a reason could be found for the relatively high rate of suture leaks after low resection of the rectum or not. The insertion of the levator muscle is a sort of vessel divide: caudal to the levator muscle the inferior rectal artery is the main supplying vessel, cranially the superior rectal artery. Here a vessel deficient-area always remains in the dorso-caudal sector of the rectal ampulla which cannot be compensated by another rectum-supplying vessel. The middle rectal artery supplies the rectum accessorily. The results are able to explain why the suture leaks are constantly observed in the dorso-caudal ampulla after profound anterior resection of the rectum. Furthermore the results account for the good healing tendency of coloanal anastomoses: the inferior rectal artery amply supplies the anal canal; there is not the same vessel-deficient area as found cranial to the levator muscle.