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

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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.

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Data availability

The data in the present study are not publicly available because of privacy and ethical reasons but can be obtained from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank Dr. Junji Kishimoto of the Center for Clinical and Translational Research at Kyushu University for his assistance with statistical methods used in this study. We thank Jane Charbonneau, DVM, and Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

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

Authors
  1. Takaaki Fujimoto
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  2. Koji Tamura
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  3. Kinuko Nagayoshi
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  4. Yusuke Mizuuchi
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Contributions

TF performed the data collection, analysis, and interpretation and wrote the manuscript. KT performed data acquisition and identified and quantified the images. KN and YM contributed to patient management, performed the data acquisition, and revised the manuscript. FG and HM performed the data acquisition. KH, KS, KN and KO revised the manuscript. MN revised and approved the final version of this manuscript.

Corresponding authors

Correspondence to Takaaki Fujimoto or Masafumi Nakamura.

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Conflicts of interest

All the authors declare no conflicts of interest for this article.

Ethical approval

This retrospective study was performed at a single institution and approved by the Ethics Committee of Kyushu University (Number: 2023–68).

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Fujimoto, T., Tamura, K., Nagayoshi, K. et al. Simple pelvimetry predicts the pelvic manipulation time in robot-assisted low and ultra-low anterior resection for rectal cancer. Surg Today (2024). https://doi.org/10.1007/s00595-024-02820-2

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