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Defining Pelvic Factors in Sphincter-Preservation of Low Rectal Cancer with a Three-Dimensional Digital Model of Pelvis

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Diseases of the Colon & Rectum

Purpose

Surgeons often can contribute failure of sphincter-preserving procedure to a limitation of pelvis anatomy; however, they cannot determine definitely which anatomic diameter or spatial factor actually affected the success of the procedure.

Methods

Colorectal surgeons, radiologists, and research fellows collaborated closely to establish a three-dimensional digital model of the pelvis with spiral computerized tomography scanning data of patients with rectal cancer. Retrospective analysis on data of 97 patients with low rectal cancer was performed with this model to identify geometric factors that might affect a successful sphincter preservation procedure for low rectal cancer.

Results

A digital pelvic model was established. Multivariate analysis demonstrated that distance from the anal verge, body mass index, and pelvic factors affected the success of sphincter preservation. Sphincter preservation was more likely to succeed when the distance from anal verge was ≥5 cm and body mass index was <25 kg/m2. Shorter diameter from the upper pubis to the sacrococcyx, distance of sacrococcyx, and excessive curvature of the sacrum predicted failure of sphincter preservation in certain cases.

Conclusions

Pelvic diameters could affect the success of sphincter preservation for low rectal cancer patients besides the distance from anal verge and body mass index.

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Authors and Affiliations

  1. Department of Surgery, School of Oncology, Peking University, Beijing, 100036, China

    Jin Gu M.D., Ai Wen Wu M.D., Ming Li M.D., Qi An M.D. & Hong Yi Wang M.D.

  2. Biomedical Engineering, Department of Mechanics and Engineering Science, Peking University, Beijing, China

    Xue Feng Bo Ph.D., Chun Yang Xiong Ph.D. & Jing Fang Ph.D.

  3. Department of Radiology, School of Oncology, Peking University, Beijing, China

    Xiao Peng Zhang M.D., Jie Li M.D. & Xuan Zhang M.D.

  4. Department of Medical Statistics, School of Oncology, Peking University, Beijing, China

    Fei Gao M.D.

  5. Department of Epidemiology, School of Oncology, Peking University, Beijing, China

    Wei Cheng You M.D.

Authors
  1. Jin Gu M.D.
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  2. Xue Feng Bo Ph.D.
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  3. Chun Yang Xiong Ph.D.
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  4. Ai Wen Wu M.D.
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  5. Xiao Peng Zhang M.D.
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  6. Ming Li M.D.
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  7. Qi An M.D.
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  8. Jing Fang Ph.D.
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  9. Jie Li M.D.
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  10. Xuan Zhang M.D.
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  11. Hong Yi Wang M.D.
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  12. Fei Gao M.D.
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  13. Wei Cheng You M.D.
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Additional information

Supported by Biomed-X Center of Peking University.

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Gu, J., Bo, X.F., Xiong, C.Y. et al. Defining Pelvic Factors in Sphincter-Preservation of Low Rectal Cancer with a Three-Dimensional Digital Model of Pelvis. Dis Colon Rectum 49, 1517–1526 (2006). https://doi.org/10.1007/s10350-006-0665-4

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  • DOI: https://doi.org/10.1007/s10350-006-0665-4

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