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01-01-2018 | Original Article

Pelvic inlet shape measured by three-dimensional pelvimetry is a predictor of the operative time in the anterior resection of rectal cancer

Authors: Takehiro Shimada, Masashi Tsuruta, Hirotoshi Hasegawa, Koji Okabayashi, Takashi Ishida, Yusuke Asada, Hirofumi Suzumura, Yuko Kitagawa

Published in: Surgery Today | Issue 1/2018

Abstract

Purpose

We evaluated pelvic shape as a predictor of the surgical outcome of anterior resection in patients with rectal cancer.

Methods

In total, 228 patients who had undergone anterior resection (R0 resection and double-stapling anastomosis) for rectal cancer from 2005 to 2014 were included in this study. The anteroposterior (AP) and transverse (T) diameters of the pelvic inlet and outlet and pelvic depth were analyzed on three-dimensional volume-rendered images, and the AP/T ratio was calculated. Univariate and multivariate analyses were performed to determine the predictive significance of the operative time and intraoperative blood loss as surgical outcomes.

Results

No difference was observed between the inlet AP/T and patient sex ratios, but the other pelvic dimensions were significantly shorter in males than in females. The univariate analysis revealed that the operative time was significantly correlated with the inlet T diameter and that it tended to be correlated with the outlet T diameter and the inlet AP/T ratio. A multivariate analysis adjusted for operation-related factors revealed that the inlet AP/T ratio was the only independent risk factor for an extended operative time (p = 0.036). None of the pelvic dimensions were independent risk factors for increased blood loss.

Conclusion

The shape of the pelvic inlet may be useful for predicting the operative time.

Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg. 2007;246(4):655–62 (Discussion 62-4).CrossRefPubMed

Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, et al. Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg. 2014;260(1):23–30.CrossRefPubMed

Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 2007;25(21):3061–8.CrossRefPubMed

Yamamoto S, Ito M, Okuda J, Fujii S, Yamaguchi S, Yoshimura K, et al. Laparoscopic surgery for stage 0/I rectal carcinoma: short-term outcomes of a single-arm phase II trial. Ann Surg. 2013;258(2):283–8.CrossRefPubMed

Kuroyanagi H, Oya M, Ueno M, Fujimoto Y, Yamaguchi T, Muto T. Standardized technique of laparoscopic intracorporeal rectal transection and anastomosis for low anterior resection. Surg Endosc. 2008;22(2):557–61.CrossRefPubMed

Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk E S, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324–32.CrossRefPubMed

Jeong Seung-Yong, Park Ji Won, Nam Byung Ho, Kim Sohee, Kang Sung-Bum, Lim Seok-Byung, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15:767–74.CrossRefPubMed

Stevenson AR, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ, et al. Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA. 2015;314(13):1356–63.CrossRefPubMed

Fleshman J, Branda M, Sargent DJ, Boller AM, George V, Abbas M, et al. Effect of laparoscopic-assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: the ACOSOG Z6051 randomized clinical trial. JAMA. 2015;314(13):1346–55.CrossRefPubMedPubMedCentral

10.

Williams NS. The rectal “no man’s land” and sphincter preservation during rectal excision. Br J Surg. 2010;97(12):1749–51.CrossRefPubMed

11.

Narumoto K, Sugimura M, Saga K, Matsunaga Y. Changes in pelvic shape among Japanese pregnant women over the last 5 decades. J Obstet Gynaecol Res. 2015;41(11):1687–92.CrossRefPubMed

12.

Targarona EM, Balague C, Pernas JC, Martinez C, Berindoague R, Gich I, et al. Can we predict immediate outcome after laparoscopic rectal surgery? Multivariate analysis of clinical, anatomic, and pathologic features after 3-dimensional reconstruction of the pelvic anatomy. Ann Surg. 2008;247(4):642–9.CrossRefPubMed

13.

Ogiso S, Yamaguchi T, Hata H, Fukuda M, Ikai I, Yamato T, et al. Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: “narrow pelvis” is not a contraindication. Surg Endosc. 2011;25(6):1907–12.CrossRefPubMed

14.

Wang C, Xiao Y, Qiu H, Yao J, Pan W. Factors affecting operating time in laparoscopic anterior resection of rectal cancer. World J Surg Oncol. 2014;12(44):1–6.PubMedPubMedCentral

15.

Salerno G, Daniels IR, Brown G, Norman AR, Moran BJ, Heald RJ. Variations in pelvic dimensions do not predict the risk of circumferential resection margin (CRM) involvement in rectal cancer. World J Surg. 2007;31(6):1313–20.CrossRefPubMed

16.

Ferko A, Maly O, Orhalmi J, Dolejs J. CT/MRI pelvimetry as a useful tool when selecting patients with rectal cancer for transanal total mesorectal excision. Surg Endosc. 2015;30:1164–71.CrossRefPubMed

17.

Akiyoshi T, Kuroyanagi H, Oya M, Konishi T, Fukuda M, Fujimoto Y, et al. Factors affecting the difficulty of laparoscopic total mesorectal excision with double stapling technique anastomosis for low rectal cancer. Surgery. 2009;146(3):483–9.CrossRefPubMed

18.

Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, et al. The international position on laparoscopic liver surgery. Ann Surg. 2009;250(5):825–30.CrossRefPubMed

19.

Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 2015;20(2):207–39.CrossRefPubMedPubMedCentral

20.

Rosset A, Spadola L, Ratib O. OsiriX: an open-source software for navigating in multidimensional DICOM images. J Digit Imaging. 2004;17(3):205–16.CrossRefPubMedPubMedCentral

21.

Spörri S, Thoeny HC, Raio L, Lachat R, Vock P, Schneider H. MR imaging pelvimetry: A useful adjunct in the treatment of women at risk for dystocia? Am J Roentgenol. 2002;179:137–44.CrossRef

22.

Killeen T, Banerjee S, Vijay V, Al-Dabbagh Z, Francis D, Warren S. Magnetic resonance (MR) pelvimetry as a predictor of difficulty in laparoscopic operations for rectal cancer. Surg Endosc. 2010;24(12):2974–9.CrossRefPubMed

23.

Oshiro Y, Mitani J, Okada T, Ohkohchi N. A novel three-dimensional print of liver vessels and tumors in hepatectomy. Surg Today. 2017;47(4):521–4.CrossRefPubMed

24.

Miyamoto R, Oshiro Y, Nakayama K, Kohno K, Hashimoto S, Fukunaga K, et al. Three-dimensional simulation of pancreatic surgery showing the size and location of the main pancreatic duct. Surg Today. 2017;47(3):357–64.CrossRefPubMed

25.

Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46(6):668–85.CrossRefPubMed

26.

Baek SJ, Kim CH, Cho MS, Bae SU, Hur H, Min BS, et al. Robotic surgery for rectal cancer can overcome difficulties associated with pelvic anatomy. Surg Endosc. 2015;29(6):1419–24.CrossRefPubMed

27.

Fernandez Ananin S, Targarona EM, Martinez C, Pernas JC, Hernandez D, Gich I, et al. Predicting the pathological features of the mesorectum before the laparoscopic approach to rectal cancer. Surg Endosc. 2014;28(12):3458–66.CrossRefPubMed

28.

Veenhof AA, Engel AF, van der Peet DL, Sietses C, Meijerink WJ, de Lange-de Klerk E S, et al. Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study. Int J Colorectal Dis. 2008;23(5):469–75.CrossRefPubMedPubMedCentral

29.

Allen SD, Gada V, Blunt DM. Variation of mesorectal volume with abdominal fat volume in patients with rectal carcinoma: assessment with MRI. Br J Radiol. 2007;80(952):242–7.CrossRefPubMed

Title: Pelvic inlet shape measured by three-dimensional pelvimetry is a predictor of the operative time in the anterior resection of rectal cancer
Authors: Takehiro Shimada
Masashi Tsuruta
Hirotoshi Hasegawa
Koji Okabayashi
Takashi Ishida
Yusuke Asada
Hirofumi Suzumura
Yuko Kitagawa
Publication date: 01-01-2018
Publisher: Springer Japan
Published in: Surgery Today / Issue 1/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-017-1547-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pelvic inlet shape measured by three-dimensional pelvimetry is a predictor of the operative time in the anterior resection of rectal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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