Magnetic resonance (MR) pelvimetry as a predictor of difficulty in laparoscopic operations for rectal cancer
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Laparoscopic surgery for rectal cancer is now well established. Recent studies have shown no difference in survival or oncologic outcomes when laparoscopic surgery is compared to open procedures [1, 2]. The laparoscopic approach does, however, present the surgeon with inherent challenges. Previous abdominal surgery, tumours closer to the anal verge, high body mass index (BMI), and preoperative radiotherapy have been shown to increase the difficulty of laparoscopic procedures in the pelvis [3, 4, 5, 6].
It is often assumed that laparoscopic resections for rectal cancer are also complicated by a deep, narrow pelvis in which access and vision are both restricted by pelvic anatomy. Although a majority of patients undergo preoperative pelvic magnetic resonance (MR) staging, radiological measurement of the bony pelvis––pelvimetry––has not been fully assessed as a predictor of difficult laparoscopic operations.
Male sex has been shown to correlate with surgeons’ perceived difficulty of...
KeywordsRectal Cancer Laparoscopic Resection Circumferential Resection Margin Sacral Promontory Pelvic Anatomy
Drs. Killeen and Dabbagh, Mr. Banerjee, Mr. Warren, Mr. Francis, and Mrs. Vijay have no conflicts of interest or financial ties to disclose.
- 5.Targarona E, Balague C, Pernas J, Martinez C, Berindoague R, Gich I, Trias M (2008) 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 247(4):642–649CrossRefPubMedGoogle Scholar