Lack of striated muscle fibers in the longitudinal anal muscle of elderly Japanese: a histological study using cadaveric specimens

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• 作者：Ji Hyun Kim (1)
  Yusuke Kinugasa (2)
  Hee Chul Yu (3) (6)
  Gen Murakami (4)
  Shinichi Abe (5)
  Baik Hwan Cho (3)
  
  1. Department of Anatomy ; Chonbuk National University Medical School ; Jeonju ; Korea
  2. Division of Colon and Rectal Surgery ; Shizuoka Cancer Center Hospital ; Sizuoka ; Japan
  3. Department of Surgery and Biomedical Research Institute ; Chonbuk National University Medical School ; Jeonju ; Korea
  6. Department of Surgery ; Chonbuk National University Hospital ; Jeonju ; Korea
  4. Division of Internal Medicine ; Iwamizawa Asuka Hospital ; Hokkaido ; Japan
  5. Department of Anatomy ; Tokyo Dental College ; Tokyo ; Japan
  
• 关键词：Longitudinal anal muscle ; Conjoint longitudinal muscle coat ; Smooth muscle ; Striated muscle ; Levator ani ; Integral pelvic floor theory
• 刊名：International Journal of Colorectal Disease
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：30
• 期：1
• 页码：43-49
• 全文大小：2,319 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Internal Medicine
  Gastroenterology
  Hepatology
  Proctology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1262

文摘

Purpose and methods The aim of this study is to investigate variations in the longitudinal anal muscle (LAM), especially in the meeting pattern between the levator ani and rectum at the origin of the LAM. We examined the histology of the anal canal and the lower rectum of 50 cadavers (25 males, 25 females) of elderly Japanese individuals with the aid of immunohistochemistry. Results We observed two patterns in the meeting site between the levator ani and the rectum. In type 1, observed in 26 specimens, the smooth muscle-rich fascia lining the internal or medial aspect of the levator ani (i.e., the fascia pelvis parietalis or endopelvic fascia) was connected to the external muscle layer. In type 2, observed in 24 specimens, multiple intramuscular septa of the levator ani were attached to a smooth muscle mass, with the latter joining the external smooth muscle layer of the rectum. However, 21 specimens (6 type 1 and 15 type 2) carried few smooth muscles at the meeting site. We did not find any striated muscle in the LAM, although this might have been the result of age-associated degeneration. Thus, active traction of the pelvic viscera by the LAM seemed unlikely in elderly Japanese. Conclusions Rather than playing an active role, as suggested by the integral pelvic floor theory, the LAM seemed to be an elastic skeleton that maintains the shape of the anal canal.