Background: Several different anatomical definitions of the rectum and its parts are used in clinical practice and relative investigational trials, rendering interpretation of results challenging.
Main Body: In the present study, current literature and guidelines in use are reviewed with regards to the anatomical definition of the rectum and their implementation in the management of rectal cancer. We identified the sigmoid cut-off on MRI being accepted by most experts as a precise and easily reproducible landmark for the upper end of the rectum. It has not been validated yet for the accuracy of its identification by the average radiologist.
Conclusion: Giving the need for interchanging experience worldwide, the development of a globally accepted anatomical definition of the rectum with easily recognized upper and lower borders based on MRI imaging is emphasised. This definition should be used for all future trials.
Key words: rectal cancer, rectal surgery, magnetic resonance imaging, rectal anatomy
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