(2) The visceral peritoneum
accounts for what percent of the total peritoneal surface?
If the visceral peritoneum
or bowel is breached during adhesiolysis, and mucosa is exposed, surgical repair is necessary
Their unusual location within the cells of the visceral peritoneum
of the ovarian tubules suggests that these oocytes are abnormally transported here following their origin in the germinal epithelium on the other side of the hemal sinus (Inoue and Shirai, 1991; Frick et al., 1996).
--Tumor invades through the muscularis propria into the subserosal adipose tissue or the nonper itonealized pericolic or perirectal soft tissues but does not extend to the serosal surface (visceral peritoneum
On the other hand, studies of closure of both parietal and visceral peritoneum
at cesarean delivery suggest that peritoneal nonclosure does not promote, and might even decrease, adhesion formation.
In contrast the visceral peritoneum
of the small bowel is seeded sparsely (3).
--pT4: Tumor penetrates visceral peritoneum
(serosa) or invades other organs
Several randomized trials have demonstrated that closure of the parietal or visceral peritoneum
--pT4: Tumor invades visceral peritoneum
(serosal) or other organs or adjacent structures
The serosal surface (visceral peritoneum
) does not constitute a surgical margin.
On the first point, the most advanced histologic category for local invasion by CRC (pT4) has been subdivided previously into those tumors showing invasion of other organs or structures and those cases that involve or penetrate (previously termed perforate) the visceral peritoneum
. In former guidelines, (7-9) these have been classified as T4a and T4b, respectively.
In 2000, the T4 category, which is the highest one for local extent of colorectal tumor and includes both extension into an adjacent structure or organ and tumor involving the visceral peritoneum
, was subdivided into T4a and T4b.