Definition of the rectum and level of the peritoneal reflection – still a matter of debate?

INTRODUCTION: Pathological lesions of the rectum are common and their management requires detailed knowledge of pelvic anatomy. There has been considerable debate as to the definition of the rectum and the variability of the level of the peritoneal reflection. The lack of a clear consensus was proven in the research by McCullen et al. regarding the current pattern of practice for the investigation of primary rectal cancer by general surgeons. AIM: To carry out bibliographic research on the definition of the rectum and level of the peritoneal reflection. MATERIAL AND METHODS: A web-based published literature search of PubMed, Ovid Medline, Science Direct and Springer was made. RESULTS: The paper presents the current definitions of proximal and distal margin of the rectum and level of peritoneal reflection based not only on the results of tests on cadavers but also on living humans. CONCLUSIONS: The results of tests on living humans allow more accurate qualification of patients for local excision, which is particularly important for patients with colorectal cancer.