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Erschienen in: European Surgery 6/2015

01.12.2015 | Original Article

Factors affecting the difficulty of laparoscopic total mesorectal excision for mid- to lower rectal cancer

verfasst von: W.-S. Lee, MD,PhD,FACS, S. W. Park, MD, J.-H. Baek, MD, PhD

Erschienen in: European Surgery | Ausgabe 6/2015

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Summary

Background

The purpose of this study was to evaluate the predictive value of clinical and anatomical features on magnetic resonance imaging (MRI) that can affect pelvic dissection time for treating mid- to lower rectal cancer.

Methods

A total of 90 consecutive male patients who underwent total mesorectal excision for mid- to lower rectal cancer were retrospectively assessed. MRI pelvimetry data were analyzed to identify anatomical features that could affect pelvic dissection time.

Results

Univariate analysis indicated that tumor distance from the anal verge (p = 0.001), preoperative chemoradiotherapy (p  = 0.002), and interspinous distance (p = 0.002) were significantly associated with pelvic dissection time.

Conclusion

Patients with a short interspinous distance may require a longer pelvic dissection time for treating rectal cancer by resection.
Literatur
1.
Zurück zum Zitat Hohenberger W. The effect of specialization or organization of rectal cancer surgery. In: Søreide PDO, Norstein DJ, editors. Rectal cancer surg. [Internet]. Berlin: Springer; 1997. S. 353–63.CrossRef Hohenberger W. The effect of specialization or organization of rectal cancer surgery. In: Søreide PDO, Norstein DJ, editors. Rectal cancer surg. [Internet]. Berlin: Springer; 1997. S. 353–63.CrossRef
2.
Zurück zum Zitat Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J, et al. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet. 2009;373:821–8.PubMedCentralCrossRefPubMed Quirke P, Steele R, Monson J, Grieve R, Khanna S, Couture J, et al. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet. 2009;373:821–8.PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat MacFarlane JK, Ryall RDH, Heald RJ. Mesorectal excision for rectal cancer. Lancet. 1993;341:457–60.CrossRefPubMed MacFarlane JK, Ryall RDH, Heald RJ. Mesorectal excision for rectal cancer. Lancet. 1993;341:457–60.CrossRefPubMed
4.
Zurück zum Zitat Nagtegaal ID, van de Velde CJH, van der Worp E, Kapiteijn E, Quirke P, van Krieken JHJM, et al. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol. 2002;20:1729–34.CrossRefPubMed Nagtegaal ID, van de Velde CJH, van der Worp E, Kapiteijn E, Quirke P, van Krieken JHJM, et al. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol. 2002;20:1729–34.CrossRefPubMed
5.
Zurück zum Zitat Heald R, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82.CrossRefPubMed Heald R, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82.CrossRefPubMed
6.
Zurück zum Zitat 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;31:1313–20.CrossRefPubMed 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;31:1313–20.CrossRefPubMed
7.
Zurück zum Zitat Veenhof AAFA, Engel AF, van der Peet DL, Sietses C, Meijerink WJHJ, de Lange-de Klerk ESM, et al. Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study. Int J Colorectal Dis. 2008;23:469–75.PubMedCentralCrossRefPubMed Veenhof AAFA, Engel AF, van der Peet DL, Sietses C, Meijerink WJHJ, de Lange-de Klerk ESM, et al. Technical difficulty grade score for the laparoscopic approach of rectal cancer: a single institution pilot study. Int J Colorectal Dis. 2008;23:469–75.PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat 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;146:483–9.CrossRefPubMed 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;146:483–9.CrossRefPubMed
9.
Zurück zum Zitat 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;25:1907–12.CrossRefPubMed 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;25:1907–12.CrossRefPubMed
10.
Zurück zum Zitat Boyle KM, Petty D, Chalmers AG, Quirke P, Cairns A, Finan PJ, et al. MRI assessment of the bony pelvis may help predict resectability of rectal cancer. Colorectal Dis. 2005;7:232–40.CrossRefPubMed Boyle KM, Petty D, Chalmers AG, Quirke P, Cairns A, Finan PJ, et al. MRI assessment of the bony pelvis may help predict resectability of rectal cancer. Colorectal Dis. 2005;7:232–40.CrossRefPubMed
11.
Zurück zum Zitat Stark DD, McCarthy SM, Filly RA, Parer JT, Hricak H, Callen PW. Pelvimetry by magnetic resonance imaging. AJR Am J Roentgenol. 1985;144:947–50.CrossRefPubMed Stark DD, McCarthy SM, Filly RA, Parer JT, Hricak H, Callen PW. Pelvimetry by magnetic resonance imaging. AJR Am J Roentgenol. 1985;144:947–50.CrossRefPubMed
12.
Zurück zum Zitat 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;247:642–9.CrossRefPubMed 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;247:642–9.CrossRefPubMed
Metadaten
Titel
Factors affecting the difficulty of laparoscopic total mesorectal excision for mid- to lower rectal cancer
verfasst von
W.-S. Lee, MD,PhD,FACS
S. W. Park, MD
J.-H. Baek, MD, PhD
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2015
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-015-0354-4

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