Prediction of Anastomotic Leakage After Laparoscopic Low Anterior Resection in Male Rectal Cancer by Pelvic Measurement in Magnetic Resonance Imaging

Overview

Journal Surg Laparosc Endosc Percutan Tech

Specialties Gastroenterology
General Surgery
Radiology

Date 2017 Jan 17

PMID 28092330

Citations 12

Authors

Atsushi Tsuruta

Jo Tashiro

Toshimasa Ishii

Yasuo Oka

Asami Suzuki

Hiroka Kondo

Shigeki Yamaguchi

Affiliations

Soon will be listed here.

Abstract

Objective: Anastomotic leakage after laparoscopic low anterior resection in male rectal cancer patients with a narrow pelvis cannot be easily resolved. The objective of this study is to assess numerical information of narrow pelvis and to determine whether prediction of morbidity can be possible.

Methods: Retrospective medical record review was performed. From July 2007 to January 2013, 43 consecutive male patients with low rectal cancer who underwent laparoscopic low anterior resection were divided into the anastomotic leakage-negative group and anastomotic leakage-positive group. Eleven anatomic parameters were measured from preoperative magnetic resonance imaging of pelvis and a new index called "pelvic index" was calculated.

Results: The pelvic index (difference between the interspinous distance and the diameter of the mesorectum divided by the depth of the cavity of the lesser pelvis) in the leakage-positive group was significantly smaller than that in the negative group (P=0.038). Comparison between those 2 groups at the border of the cut-off value of the pelvic index (13.0) showed a significant difference.

Conclusions: Preoperative assessment by the pelvic index can predict the narrow pelvis and risk of anastomotic leakage.

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References

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(3):1164-71. DOI: 10.1007/s00464-015-4324-5. View

Nelson H, Sargent D, Wieand H, Fleshman J, Anvari M, Stryker S . A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004; 350(20):2050-9. DOI: 10.1056/NEJMoa032651. View

Boyle K, Petty D, Chalmers A, Quirke P, Cairns A, Finan P . MRI assessment of the bony pelvis may help predict resectability of rectal cancer. Colorectal Dis. 2005; 7(3):232-40. DOI: 10.1111/j.1463-1318.2005.00819.x. View

Baik S, Kim N, Lee K, Sohn S, Cho C, Kim M . Factors influencing pathologic results after total mesorectal excision for rectal cancer: analysis of consecutive 100 cases. Ann Surg Oncol. 2007; 15(3):721-8. DOI: 10.1245/s10434-007-9706-z. View

Heald R, Moran B, Ryall R, Sexton R, Macfarlane J . Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997. Arch Surg. 1998; 133(8):894-9. DOI: 10.1001/archsurg.133.8.894. View

Kim J, Kim Y, Kim N, Hur H, Lee K, Min B . Pelvic anatomy as a factor in laparoscopic rectal surgery: a prospective study. Surg Laparosc Endosc Percutan Tech. 2011; 21(5):334-9. DOI: 10.1097/SLE.0b013e31822b0dcb. View

Heald R, Husband E, Ryall R . The mesorectum in rectal cancer surgery--the clue to pelvic recurrence?. Br J Surg. 1982; 69(10):613-6. DOI: 10.1002/bjs.1800691019. View

Mason B, Hakimi A, Faleck D, Chernyak V, Rozenblitt A, Ghavamian R . The role of preoperative endo-rectal coil magnetic resonance imaging in predicting surgical difficulty for robotic prostatectomy. Urology. 2010; 76(5):1130-5. DOI: 10.1016/j.urology.2010.05.037. View

Stark D, McCarthy S, Filly R, Parer J, Hricak H, Callen P . Pelvimetry by magnetic resonance imaging. AJR Am J Roentgenol. 1985; 144(5):947-50. DOI: 10.2214/ajr.144.5.947. View

10.

Jung S, Yu C, Choi P, Dong Kim D, Park I, Kim H . Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum. 2008; 51(6):902-8. DOI: 10.1007/s10350-008-9272-x. View

11.

Keller T, Rake A, Michel S, Seifert B, Efe G, Treiber K . Obstetric MR pelvimetry: reference values and evaluation of inter- and intraobserver error and intraindividual variability. Radiology. 2003; 227(1):37-43. DOI: 10.1148/radiol.2271011658. View

12.

Lun Law W, Lee Y, Kwok Choi H, Seto C, Ho J . Laparoscopic and open anterior resection for upper and mid rectal cancer: an evaluation of outcomes. Dis Colon Rectum. 2006; 49(8):1108-15. DOI: 10.1007/s10350-006-0551-0. View

13.

Leung K, Kwok S, Lam S, Lee J, Yiu R, Ng S . Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet. 2004; 363(9416):1187-92. DOI: 10.1016/S0140-6736(04)15947-3. View

14.

Akiyoshi T, Kuroyanagi H, Oya M, Konishi T, Fukuda M, Fujimoto Y . Factors affecting the difficulty of laparoscopic total mesorectal excision with double stapling technique anastomosis for low rectal cancer. Surgery. 2009; 146(3):483-9. DOI: 10.1016/j.surg.2009.03.030. View

15.

Braga M, Frasson M, Vignali A, Zuliani W, Civelli V, Di Carlo V . Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival. Dis Colon Rectum. 2005; 48(12):2217-23. DOI: 10.1007/s10350-005-0185-7. View

16.

Seki Y, Ohue M, Sekimoto M, Takiguchi S, Takemasa I, Ikeda M . Evaluation of the technical difficulty performing laparoscopic resection of a rectosigmoid carcinoma: visceral fat reflects technical difficulty more accurately than body mass index. Surg Endosc. 2007; 21(6):929-34. DOI: 10.1007/s00464-006-9084-9. View

17.

Salerno G, Daniels I, Brown G, Norman A, Moran B, Heald R . 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. DOI: 10.1007/s00268-007-9007-5. View

18.

Salerno G, Daniels I, Brown G, Heald R, Moran B . Magnetic resonance imaging pelvimetry in 186 patients with rectal cancer confirms an overlap in pelvic size between males and females. Colorectal Dis. 2006; 8(9):772-6. DOI: 10.1111/j.1463-1318.2006.01090.x. View

19.

Ogiso S, Yamaguchi T, Hata H, Fukuda M, Ikai I, Yamato T . Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: "narrow pelvis" is not a contraindication. Surg Endosc. 2010; 25(6):1907-12. DOI: 10.1007/s00464-010-1485-0. View

20.

Lacy A, Garcia-Valdecasas J, Delgado S, Castells A, Taura P, Pique J . Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002; 359(9325):2224-9. DOI: 10.1016/S0140-6736(02)09290-5. View