Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2018

Open Access 01-12-2018 | Research

Anatomical basis for the choice of laparoscopic surgery for low rectal cancer through the pelvic imaging data—a cohort study

Authors: Zhou Yang, Guo Chunhua, Yuan Huayan, Yang Jianguo, Cheng Yong

Published in: World Journal of Surgical Oncology | Issue 1/2018

Login to get access

Abstract

Background

Low rectal cancer surgery without anus conservation needs permanent ileostomy or colostomy which seriously affects the quality of life of patients. Therefore, low rectal cancer surgery not only pays attention to the safety of surgical treatment but also to the anus conservation.

Methods

Sixty-seven patients suffering from low rectal cancer had undergone laparoscopic surgery which was analyzed through retrospective study. They were divided into the anus-conserving and non-anus-conserving groups. Thirty-five set of pelvic data was obtained from the preoperative CT and MRI images. After that, the discriminant function was obtained to predict the surgery methods for patients with low rectal carcinoma.

Results

Anal-conserving group discriminant function (F1) = − 33.698 + 6.045 × anal margin distance (cm) + 1.105 × T4; non-anus-conserving group discriminant function (F2) = − 14.125 + 3.138 × anal margin distance (cm) + 0.804 × T4. If F1 is greater than F2, then the case can be treated as the anus reservation while if F2 is greater than F1 the case cannot be treated anus reservation. The accuracy of the discriminant function was evaluated which was found to be 97%.

Conclusion

The discriminant function of pelvic data provides anatomical basis for the choice of surgical methods for low rectal cancer.
Literature
1.
go back to reference Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence. Br J Surg. 1982;69:613–6.CrossRef Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence. Br J Surg. 1982;69:613–6.CrossRef
2.
go back to reference Maglio R, Meucci M, Muzi MG, Maglio M, Masoni L. Laparoscopic total mesorectal excision for ultralow rectal cancer with transanal intersphincteric dissection as a first step: a single-surgeon experience. Am Surg. 2014;80:26–30.PubMed Maglio R, Meucci M, Muzi MG, Maglio M, Masoni L. Laparoscopic total mesorectal excision for ultralow rectal cancer with transanal intersphincteric dissection as a first step: a single-surgeon experience. Am Surg. 2014;80:26–30.PubMed
3.
go back to reference Christoforidis D, Demartines N. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96:982–9.CrossRef Christoforidis D, Demartines N. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96:982–9.CrossRef
4.
go back to reference Ng SS, Leung KL, Lee JF, Yiu RY, Li JC, Teoh AY, Leung WW. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer:a prospective randomized trial. Ann Surg Oncol. 2008;15:2418–25.CrossRef Ng SS, Leung KL, Lee JF, Yiu RY, Li JC, Teoh AY, Leung WW. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer:a prospective randomized trial. Ann Surg Oncol. 2008;15:2418–25.CrossRef
5.
go back to reference M. Roh, N. Petrelli, H. Wieand, Phase III randomised trial of preoperative versus postoperative mutimodality therapy in patients with carcinoma of the rectum (NSABP R-03). J. Clin. Oncol 20 (2001) Abstract 450. M. Roh, N. Petrelli, H. Wieand, Phase III randomised trial of preoperative versus postoperative mutimodality therapy in patients with carcinoma of the rectum (NSABP R-03). J. Clin. Oncol 20 (2001) Abstract 450.
6.
go back to reference Sauer R, Fietkau R, Wittekind C, Rödel C, Martus P, Hohenberger W, Tschmelitsch J, Sabitzer H, Karstens JH, Becker H, Hess C, Raab R. German Rectal Cancer Group, Adjuvant vs. neoadjuvant radiochemotherapy for locally advanced rectal cancer: the German trial CAO/ARO/AIO-94. Colorectal Dis. 2003;5(2003):406–15.CrossRef Sauer R, Fietkau R, Wittekind C, Rödel C, Martus P, Hohenberger W, Tschmelitsch J, Sabitzer H, Karstens JH, Becker H, Hess C, Raab R. German Rectal Cancer Group, Adjuvant vs. neoadjuvant radiochemotherapy for locally advanced rectal cancer: the German trial CAO/ARO/AIO-94. Colorectal Dis. 2003;5(2003):406–15.CrossRef
7.
go back to reference Mulsow J, Winter DC. Sphincter preservation for distal rectal cancer - a goal worth achieving at all costs. World J Gastroenterol. 2011;17:855–61.CrossRef Mulsow J, Winter DC. Sphincter preservation for distal rectal cancer - a goal worth achieving at all costs. World J Gastroenterol. 2011;17:855–61.CrossRef
8.
go back to reference Orsenigo E, Di Palo S, Vignali A, Staudacher C. Laparoscopic intersphincteric resection for low rectal cancer,Surg. Oncologia. 2007;16:S117–20. Orsenigo E, Di Palo S, Vignali A, Staudacher C. Laparoscopic intersphincteric resection for low rectal cancer,Surg. Oncologia. 2007;16:S117–20.
9.
go back to reference Zhou X, Su M, Hu K, Su Y, Ye Y, Huang C, Yu Z, Li X, Zhou H, Ni Y, Jiang Y. Applications of computed tomography pelvimetry and clinical-pathological parameters in sphincter preservation of mid-low rectal cancer. Int J Clin Exp Med. 2015;8:2174–81.PubMedPubMedCentral Zhou X, Su M, Hu K, Su Y, Ye Y, Huang C, Yu Z, Li X, Zhou H, Ni Y, Jiang Y. Applications of computed tomography pelvimetry and clinical-pathological parameters in sphincter preservation of mid-low rectal cancer. Int J Clin Exp Med. 2015;8:2174–81.PubMedPubMedCentral
10.
go back to reference Kuo LJ, Hung CS, Wang W, Tam KW, Lee HC, Liang HH, Chang YJ, Huang MT, Wei PL. Intersphincteric resection for very low rectal cancer: clinical outcomes of open versus laparoscopic approach and multidimensional analysis of the learning curve for laparoscopic surgery. J Surg Res. 2013;524:530. Kuo LJ, Hung CS, Wang W, Tam KW, Lee HC, Liang HH, Chang YJ, Huang MT, Wei PL. Intersphincteric resection for very low rectal cancer: clinical outcomes of open versus laparoscopic approach and multidimensional analysis of the learning curve for laparoscopic surgery. J Surg Res. 2013;524:530.
11.
go back to reference Boyle KM, Petty D, Chalmers AG, Quirke P, Cairns A, Finan PJ, Sagar PM, Burke D. Mri assessment of the bony pelvis may help predict resectability of rectal cancer. Color Dis. 2005;7:232–40.CrossRef Boyle KM, Petty D, Chalmers AG, Quirke P, Cairns A, Finan PJ, Sagar PM, Burke D. Mri assessment of the bony pelvis may help predict resectability of rectal cancer. Color Dis. 2005;7:232–40.CrossRef
12.
go back to reference Targarona EM, Balague C, Pernas JC, Martinez C, Berindoague R, Gich I, Trias M. 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;247:642–9.CrossRef Targarona EM, Balague C, Pernas JC, Martinez C, Berindoague R, Gich I, Trias M. 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;247:642–9.CrossRef
13.
go back to reference Fernández Ananín S, Targarona EM, Martinez C, Pernas JC, Hernández D, Gich I, Sancho FJ, Trias M. Predicting the pathological features of the mesorectum before the laparoscopic approach to rectal cancer. Surg. Endosc. 2014;28:3458–66.CrossRef Fernández Ananín S, Targarona EM, Martinez C, Pernas JC, Hernández D, Gich I, Sancho FJ, Trias M. Predicting the pathological features of the mesorectum before the laparoscopic approach to rectal cancer. Surg. Endosc. 2014;28:3458–66.CrossRef
14.
go back to reference Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP. For the STROCSS Group, The STROCSS statement: strengthening the reporting of cohort studies in surgery. Int J Surg. 2017;46:198–202.CrossRef Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP. For the STROCSS Group, The STROCSS statement: strengthening the reporting of cohort studies in surgery. Int J Surg. 2017;46:198–202.CrossRef
15.
go back to reference Keller TM, Rake A, Michel SC, Seifert B, Efe G, Treiber K, Huch R, Marincek B, Kubik-Huch RA. Obstetric pelvimetry reference values and evaluation of inter-and intraobserver error and intraindividual variability. Radiology. 2003;227:37–43.CrossRef Keller TM, Rake A, Michel SC, Seifert B, Efe G, Treiber K, Huch R, Marincek B, Kubik-Huch RA. Obstetric pelvimetry reference values and evaluation of inter-and intraobserver error and intraindividual variability. Radiology. 2003;227:37–43.CrossRef
16.
go back to reference Anderson N, Humphries N, Wells JE. Measurement error in computed tomography pelvimetry, Australas. Radiol. 2005;49(2005):104–7. Anderson N, Humphries N, Wells JE. Measurement error in computed tomography pelvimetry, Australas. Radiol. 2005;49(2005):104–7.
17.
go back to reference Zhou XC, Su M, Hu KQ, Su YF, Ye YH, Huang CQ, Yu ZL, Li XY, Zhou H, Ni YZ, Jiang YI, Lou Z. CT pelvimetry and clinicopathological parameters in evaluation of the technical difficulties in performing open rectal surgery for mid-low rectal cancer. Oncol Lett. 2016;11:31–8.CrossRef Zhou XC, Su M, Hu KQ, Su YF, Ye YH, Huang CQ, Yu ZL, Li XY, Zhou H, Ni YZ, Jiang YI, Lou Z. CT pelvimetry and clinicopathological parameters in evaluation of the technical difficulties in performing open rectal surgery for mid-low rectal cancer. Oncol Lett. 2016;11:31–8.CrossRef
18.
go back to reference Zur Hausen G, Gröne J, Kaufmann D, Niehues SM, Aschenbrenner K, Stroux A, Hamm B, Kreis ME, Lauscher JC. Influence of pelvic volume on surgical outcome after low anterior resection for rectal cancer. IntJ Colorectal Dis. 2017;32:1125–35.CrossRef Zur Hausen G, Gröne J, Kaufmann D, Niehues SM, Aschenbrenner K, Stroux A, Hamm B, Kreis ME, Lauscher JC. Influence of pelvic volume on surgical outcome after low anterior resection for rectal cancer. IntJ Colorectal Dis. 2017;32:1125–35.CrossRef
19.
go back to reference Baek SJ, Kim CH, Cho MS, Bae SU, Hur H, Min BS, Baik SH, Lee KY, Kim NK. Robotic surgery for rectal cancer can overcome difficulties associated with pelvic anatomy. Surg Endosc. 2015;29:1419–24.CrossRef Baek SJ, Kim CH, Cho MS, Bae SU, Hur H, Min BS, Baik SH, Lee KY, Kim NK. Robotic surgery for rectal cancer can overcome difficulties associated with pelvic anatomy. Surg Endosc. 2015;29:1419–24.CrossRef
20.
go back to reference Tsuruta A, Tashiro J, Ishii T, Oka Y, Suzuki A, Kondo H, Yamaguchi S. Prediction of anastomotic leakage after laparoscopic low anterior resection in male rectal cancer by pelvic measurement in magnetic resonance imaging. Surg. Laparosc. Endosc. Percutan. Tech. 2017;27:54–9.PubMedPubMedCentral Tsuruta A, Tashiro J, Ishii T, Oka Y, Suzuki A, Kondo H, Yamaguchi S. Prediction of anastomotic leakage after laparoscopic low anterior resection in male rectal cancer by pelvic measurement in magnetic resonance imaging. Surg. Laparosc. Endosc. Percutan. Tech. 2017;27:54–9.PubMedPubMedCentral
21.
go back to reference Nakayama S, Hasegawa S, Hida K, Kawada K, Sakai Y. Obtaining secure stapling of a double stapling anastomosis. J Surg Res. 2015;193:652–7.CrossRef Nakayama S, Hasegawa S, Hida K, Kawada K, Sakai Y. Obtaining secure stapling of a double stapling anastomosis. J Surg Res. 2015;193:652–7.CrossRef
Metadata
Title
Anatomical basis for the choice of laparoscopic surgery for low rectal cancer through the pelvic imaging data—a cohort study
Authors
Zhou Yang
Guo Chunhua
Yuan Huayan
Yang Jianguo
Cheng Yong
Publication date
01-12-2018
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1498-z

Other articles of this Issue 1/2018

World Journal of Surgical Oncology 1/2018 Go to the issue