Evaluation of the anticipated surgical difficulties in minimally invasive rectal cancer surgery using MRI pelvimetry.
EAES Academy. Migaczewski M. 07/05/22; 363013; P056
CLICK HERE TO LOGIN
REGULAR CONTENT
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Rectal cancer is the third most common cancer related cause of death in the western countries and the risk of rectal cancer is increasing with age. Total mesorectal excision (TME) which comprises excision of the tumour with the surrounding tissue is the standard operative technique frequently combined with neoadjuvant chemo- and radiotherapy. Patient’s anatomical conditions are important factors influencing the difficulty of the procedure and can limit its quality. BMI, gender, tumour size and dimensions of the pelvic cavity are well known predictive factors of surgical difficulty in patients undergoing rectal surgery.
In order to choose the best treatment strategy, it is crucial to perform preoperative magnetic resonance (MRI) of the pelvis, a „ gold standard” in diagnostic work-up of rectal cancer patients. It determines the size and location of the tumour, its invasion of the surrounding structures and the presence of enlarged mesorectal lymph nodes. MRI allows as well to perform various pelvimetric measurements which are not ordinarily used in predicting intraoperative difficulties.
Retrospective cohort study was performed which included 110 patients with rectal cancer treated either with LAR or TaTME.
The unusual aspect of our study is the comparison of two minimally invasive surgeries – LAR and TaTME in regards to predicting intra and perioperative difficulties based on preoperative pelvimetric parameters analysis based upon MRI images. There was an increased risk or postoperative morbidity depending on the puboccocygeal distance (cut-off point 136 mm) in the TaTME group whereas there was no significant association of these parameters in the LAR group. Perhaps it is worth taking into consideration this parameter in the choice of surgical approach. There were similarities in both groups in the analysis of the risk factors of intraoperative blood los. Again, in selected cases the choice of operative technique may be supported by pelvimetric parameters
MRI based pelvimetric parameters measurement can influence surgeon’s choice of a particular surgical procedure in patients with resectable rectal cancer.
In order to choose the best treatment strategy, it is crucial to perform preoperative magnetic resonance (MRI) of the pelvis, a „ gold standard” in diagnostic work-up of rectal cancer patients. It determines the size and location of the tumour, its invasion of the surrounding structures and the presence of enlarged mesorectal lymph nodes. MRI allows as well to perform various pelvimetric measurements which are not ordinarily used in predicting intraoperative difficulties.
Retrospective cohort study was performed which included 110 patients with rectal cancer treated either with LAR or TaTME.
The unusual aspect of our study is the comparison of two minimally invasive surgeries – LAR and TaTME in regards to predicting intra and perioperative difficulties based on preoperative pelvimetric parameters analysis based upon MRI images. There was an increased risk or postoperative morbidity depending on the puboccocygeal distance (cut-off point 136 mm) in the TaTME group whereas there was no significant association of these parameters in the LAR group. Perhaps it is worth taking into consideration this parameter in the choice of surgical approach. There were similarities in both groups in the analysis of the risk factors of intraoperative blood los. Again, in selected cases the choice of operative technique may be supported by pelvimetric parameters
MRI based pelvimetric parameters measurement can influence surgeon’s choice of a particular surgical procedure in patients with resectable rectal cancer.
Rectal cancer is the third most common cancer related cause of death in the western countries and the risk of rectal cancer is increasing with age. Total mesorectal excision (TME) which comprises excision of the tumour with the surrounding tissue is the standard operative technique frequently combined with neoadjuvant chemo- and radiotherapy. Patient’s anatomical conditions are important factors influencing the difficulty of the procedure and can limit its quality. BMI, gender, tumour size and dimensions of the pelvic cavity are well known predictive factors of surgical difficulty in patients undergoing rectal surgery.
In order to choose the best treatment strategy, it is crucial to perform preoperative magnetic resonance (MRI) of the pelvis, a „ gold standard” in diagnostic work-up of rectal cancer patients. It determines the size and location of the tumour, its invasion of the surrounding structures and the presence of enlarged mesorectal lymph nodes. MRI allows as well to perform various pelvimetric measurements which are not ordinarily used in predicting intraoperative difficulties.
Retrospective cohort study was performed which included 110 patients with rectal cancer treated either with LAR or TaTME.
The unusual aspect of our study is the comparison of two minimally invasive surgeries – LAR and TaTME in regards to predicting intra and perioperative difficulties based on preoperative pelvimetric parameters analysis based upon MRI images. There was an increased risk or postoperative morbidity depending on the puboccocygeal distance (cut-off point 136 mm) in the TaTME group whereas there was no significant association of these parameters in the LAR group. Perhaps it is worth taking into consideration this parameter in the choice of surgical approach. There were similarities in both groups in the analysis of the risk factors of intraoperative blood los. Again, in selected cases the choice of operative technique may be supported by pelvimetric parameters
MRI based pelvimetric parameters measurement can influence surgeon’s choice of a particular surgical procedure in patients with resectable rectal cancer.
In order to choose the best treatment strategy, it is crucial to perform preoperative magnetic resonance (MRI) of the pelvis, a „ gold standard” in diagnostic work-up of rectal cancer patients. It determines the size and location of the tumour, its invasion of the surrounding structures and the presence of enlarged mesorectal lymph nodes. MRI allows as well to perform various pelvimetric measurements which are not ordinarily used in predicting intraoperative difficulties.
Retrospective cohort study was performed which included 110 patients with rectal cancer treated either with LAR or TaTME.
The unusual aspect of our study is the comparison of two minimally invasive surgeries – LAR and TaTME in regards to predicting intra and perioperative difficulties based on preoperative pelvimetric parameters analysis based upon MRI images. There was an increased risk or postoperative morbidity depending on the puboccocygeal distance (cut-off point 136 mm) in the TaTME group whereas there was no significant association of these parameters in the LAR group. Perhaps it is worth taking into consideration this parameter in the choice of surgical approach. There were similarities in both groups in the analysis of the risk factors of intraoperative blood los. Again, in selected cases the choice of operative technique may be supported by pelvimetric parameters
MRI based pelvimetric parameters measurement can influence surgeon’s choice of a particular surgical procedure in patients with resectable rectal cancer.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}