Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
Surgery Today
Erschienen in:

29.03.2024 | Original Article

Simple pelvimetry predicts the pelvic manipulation time in robot-assisted low and ultra-low anterior resection for rectal cancer

verfasst von: Takaaki Fujimoto, Koji Tamura, Kinuko Nagayoshi, Yusuke Mizuuchi, Fumika Goto, Hironao Matsuda, Kohei Horioka, Koji Shindo, Kohei Nakata, Kenoki Ohuchida, Masafumi Nakamura

Erschienen in: Surgery Today | Ausgabe 10/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study explored the difficulty factors in robot-assisted low and ultra-low anterior resection, focusing on simple measurements of the pelvic anatomy.

Methods

This was a retrospective analysis of the clinical data of 61 patients who underwent robot-assisted low and ultra-low anterior resection for rectal cancer between October 2018 and April 2023. The relationship between the operative time in the pelvic phase and clinicopathological data, especially pelvic anatomical parameters measured on X-ray and computed tomography (CT), was evaluated. The operative time in the pelvic phase was defined as the time between mobilization from the sacral promontory and rectal resection.

Results

Robot-assisted low and ultra-low anterior resections were performed in 32 and 29 patients, respectively. The median operative time in the pelvic phase was 126 (range, 31–332) min. A multiple linear regression analysis showed that a short distance from the anal verge to the lower edge of the cancer, a narrow area comprising the iliopectineal line, short anteroposterior and transverse pelvic diameters, and a small angle of the pelvic mesorectum were associated with a prolonged operative time in the pelvic phase.

Conclusion

Simple pelvic anatomical measurements using abdominal radiography and CT may predict the pelvic manipulation time in robot-assisted surgery for rectal cancer.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Kamo KI, Fukui K, Ito Y, Nakayama T, Katanoda K. How much can screening reduce colorectal cancer mortality in Japan? Scenario-based estimation by microsimulation. Jpn J Clin Oncol. 2022;52:221–6.CrossRefPubMed
2.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72:7–33.CrossRefPubMed
3.
Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20:1521–5.CrossRefPubMed
4.
Shiroshita H, Inomata M, Akira S, Kanayama H, Yamaguchi S, Eguchi S, et al. Current status of endoscopic surgery in Japan: the 15th national survey of endoscopic surgery by the japan society for endoscopic surgery. Asian J Endosc Surg. 2022;15:415–26.CrossRefPubMed
5.
Kim MJ, Park SC, Park JW, Chang HJ, Kim DY, Nam BH, et al. Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg. 2018;267:243–51.CrossRefPubMed
6.
Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y, et al. Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol. 2022;7:991–1004.CrossRefPubMed
7.
Park JS, Lee SM, Choi GS, Park SY, Kim HJ, Song SH, et al. Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial. Ann Surg. 2023;278:31–8.CrossRefPubMed
8.
Hettiarachchi TS, Askari A, Rudge E, Hao LT, Sarwar S, Dowsett D, et al. Comparison of robotic vs laparoscopic left-sided colorectal cancer resections. J Robot Surg. 2023;17:205–13.PubMed
9.
Albayati S, Hitos K, Berney CR, Morgan MJ, Pathma-Nathan N, El-Khoury T, et al. Robotic-assisted versus laparoscopic rectal surgery in obese and morbidly obese patients: ACS-NSQIP analysis. J Robot Surg. 2023;17:637–43.CrossRefPubMed
10.
Teng W, Liu J, Chen M, Zang W, Wu A. BMI and pelvimetry help to predict the duration of laparoscopic resection for low and middle rectal cancer. BMC Surg. 2022;22:402.CrossRefPubMedPubMedCentral
11.
12.
Nagai Y, Kawai K, Nozawa H, Sasaki K, Murono K, Emoto S, et al. Three-dimensional visualization of the total mesorectal excision plane for dissection in rectal cancer surgery and its ability to predict surgical difficulty. Sci Rep. 2023;13:2130.CrossRefPubMedPubMedCentral
13.
Yamaoka Y, Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, et al. Mesorectal fat area as a useful predictor of the difficulty of robotic-assisted laparoscopic total mesorectal excision for rectal cancer. Surg Endosc. 2019;33:557–66.CrossRefPubMed
14.
Yamamoto T, Kawada K, Kiyasu Y, Itatani Y, Mizuno R, Hida K, et al. Prediction of surgical difficulty in minimally invasive surgery for rectal cancer by use of MRI pelvimetry. BJS Open. 2020;4:666–77.CrossRefPubMedPubMedCentral
15.
Brierly JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. 8th ed. New York: Wiley; 2016.
16.
Yuval JB, Thompson HM, Fiasconaro M, Patil S, Wei IH, Pappou EP, et al. Predictors of operative difficulty in robotic low anterior resection for rectal cancer. Colorectal Dis. 2022;24:1318–24.CrossRefPubMedPubMedCentral
17.
Tsuruta A, Tashiro J, Ishii T, Oka Y, Suzuki A, Kondo H, et al. 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.CrossRefPubMedPubMedCentral
18.
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;29:1419–24.CrossRefPubMed
19.
Katsuno H, Shiomi A, Ito M, Koide Y, Maeda K, Yatsuoka T, et al. Comparison of symptomatic anastomotic leakage following laparoscopic and open low anterior resection for rectal cancer: a propensity score matching analysis of 1014 consecutive patients. Surg Endosc. 2016;30:2848–56.CrossRefPubMed
20.
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
21.
Kim CW, Baek SJ, Hur H, Min BS, Baik SH, Kim NK. Anastomotic leakage after low anterior resection for rectal cancer is different between minimally invasive surgery and open surgery. Ann Surg. 2016;263:130–7.CrossRefPubMed
22.
Balk SH, Kim NK, Lee KY, Sohn SK, Cho CH, Kim MJ, et al. Factors influencing pathologic results after total mesorectal excision for rectal cancer: analysis of consecutive 100 cases. Ann Surg Oncol. 2008;15:721–8.CrossRef
23.
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
24.
Keller TM, Rake A, Michel SC, Seifert B, Efe G, Treiber K, et al. Obstetric MR pelvimetry: reference values and evaluation of inter—and intraobserver error and intraindividual variability. Radiology. 2003;227:37–43.CrossRefPubMed
25.
Korhonen U, Solja R, Laitinen J, Heinonen S, Taipale P. MR pelvimetry measurements, analysis of inter- and intra-observer variation. Eur J Radiol. 2010;75:e56-61.CrossRefPubMed
26.
Hong JS, Brown KGM, Waller J, Young CJ, Solomon MJ. The role of MRI pelvimetry in predicting technical difficulty and outcomes of open and minimally invasive total mesorectal excision: a systematic review. Tech Coloproctol. 2020;24:991–1000.CrossRefPubMed
27.
Noh GT, Chung SS, Kim KH, Lee RA. Computed tomography based cross-sectional anatomy of the pelvis predicts surgical outcome after rectal cancer surgery. Ann Surg Treat Res. 2020;99:90–6.CrossRefPubMedPubMedCentral
28.
Toyoshima A, Nishizawa T, Sunami E, Akai R, Amano T, Yamashita A, et al. Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection. World J Gastrointest Surg. 2020;12:425–34.CrossRefPubMedPubMedCentral
29.
Yang J, Chen Q, Jindou L, Cheng Y. The influence of anastomotic leakage for rectal cancer oncologic outcome: a systematic review and meta-analysis. J Surg Oncol. 2020;121:1283–97.CrossRefPubMed
30.
Balciscueta Z, Uribe N, Caubet L, López M, Torrijo I, Tabet J, et al. Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis. Tech Coloproctol. 2020;24:919–25.CrossRefPubMed
Metadaten
Titel
Simple pelvimetry predicts the pelvic manipulation time in robot-assisted low and ultra-low anterior resection for rectal cancer
verfasst von
Takaaki Fujimoto
Koji Tamura
Kinuko Nagayoshi
Yusuke Mizuuchi
Fumika Goto
Hironao Matsuda
Kohei Horioka
Koji Shindo
Kohei Nakata
Kenoki Ohuchida
Masafumi Nakamura
Publikationsdatum
29.03.2024
Verlag
Springer Nature Singapore
Erschienen in
Surgery Today / Ausgabe 10/2024
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02820-2

Weitere Artikel der Ausgabe 10/2024

Effects of transmembrane serine protease 4 on the survival in patients with pancreatic ductal adenocarcinoma undergoing surgery followed by adjuvant chemotherapy

  • Original Article

Development of a laparoscopic sigmoidectomy simulator: Sigmaster

  • Short Communication

Financial burden of surgical treatment for retroperitoneal sarcoma

  • Original Article

Ultrasound-based predictive indicators for treatment outcomes in pediatric vesicoureteral reflux

  • Open Access
  • Original Article

A silicone disc for liver retraction in laparoscopic gastrectomy reduces the postoperative increase in the liver enzyme level

  • Original Article

The role of calcification in predicting invasion of thymoma to adjacent organs

  • Original Article

Neu im Fachgebiet Chirurgie

Leitlinienkonformes Management thermischer Verletzungen

Thermische Verletzungen gehören zu den schwerwiegendsten Traumen und hinterlassen oft langfristige körperliche und psychische Spuren. Die aktuelle S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter (Verbrennung, Verbrühung)“ bietet eine strukturierte Übersicht über das empfohlene Vorgehen.

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

US-Team empfiehlt Gastropexie nach Hiatushernien-Op.

Zur Vermeidung von Rezidiven nach Reparatur einer paraösophagealen Hiatushernie sollte einem US-Team zufolge der Magen bei der Op. routinemäßig an der Bauchwand fixiert werden. Das Ergebnis einer randomisierten Studie scheint dafür zu sprechen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise