The impact of pelvimetry on anastomotic leakage in a consecutive series of open, laparoscopic and robotic low anterior resections with total mesorectal excision for rectal cancer

Emilio Bertani, Antonio Chiappa, Paolo Della Vigna, Davide Radice, Davide Papis, Laura Cossu, Roberto Biffi, Paolo P. Bianchi, Fabrizio Luca, Bruno Andreoni

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background/Aims: Recently, pelvic anatomy has been taken into consideration and related to surgical outcome indicators after low anterior resection (LAR). Several pelvimetric parameters have been matched with conversion rate, postoperative complications and duration of surgery in laparoscopic series, and with the quality of specimen and pathologic outcomes in further open surgical series. Methodology: In 97 consecutive patients submitted to sphincter-saving LAR with total mesorectal excision (TME) five pelvic dimensions were measured by abdominal computed tomography scan: anteroposterior and transverse diameters in the pelvic inlet (IAP and ITRA), anteroposterior and transverse diameters in the pelvic outlet (OAP and OTRA), and the pelvic depth. The endpoint evaluated was anastomotic leakage (AL) rate. Results: There were 51 open, 12 laparoscopic and 34 robotic LARs. The sum of IAP OAP and OTRA (Pelvic Index) significantly predicted AL showing that starting from the cut-point of 290 mm down to a PI of 278 mm the odds-ratio of having an AL increased from 2.63 (95% CI: 1.10,5.47) to 5.07 (95% CI: 1.35,8.02). Conclusions: The sum of the 3 pelvic dimensions which we termed "Pelvic Index" was associated to AL following sphincter-saving LAR. This may be considered in planning the surgical strategy for rectal cancer patients.

Original languageEnglish
Pages (from-to)1574-1581
Number of pages8
JournalHepato-Gastroenterology
Volume61
Issue number134
DOIs
Publication statusPublished - 2014

Fingerprint

Pelvimetry
Anastomotic Leak
Robotics
Rectal Neoplasms
Laparoscopy
Anatomy
Odds Ratio
Tomography

Keywords

  • Anastomotic leakage
  • Gender
  • Pelvimetry
  • Rectal cancer
  • Robotic surgery
  • Total mesorectal excision

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

Cite this

@article{f84bd83a18e24325ad362a52e363458a,
title = "The impact of pelvimetry on anastomotic leakage in a consecutive series of open, laparoscopic and robotic low anterior resections with total mesorectal excision for rectal cancer",
abstract = "Background/Aims: Recently, pelvic anatomy has been taken into consideration and related to surgical outcome indicators after low anterior resection (LAR). Several pelvimetric parameters have been matched with conversion rate, postoperative complications and duration of surgery in laparoscopic series, and with the quality of specimen and pathologic outcomes in further open surgical series. Methodology: In 97 consecutive patients submitted to sphincter-saving LAR with total mesorectal excision (TME) five pelvic dimensions were measured by abdominal computed tomography scan: anteroposterior and transverse diameters in the pelvic inlet (IAP and ITRA), anteroposterior and transverse diameters in the pelvic outlet (OAP and OTRA), and the pelvic depth. The endpoint evaluated was anastomotic leakage (AL) rate. Results: There were 51 open, 12 laparoscopic and 34 robotic LARs. The sum of IAP OAP and OTRA (Pelvic Index) significantly predicted AL showing that starting from the cut-point of 290 mm down to a PI of 278 mm the odds-ratio of having an AL increased from 2.63 (95{\%} CI: 1.10,5.47) to 5.07 (95{\%} CI: 1.35,8.02). Conclusions: The sum of the 3 pelvic dimensions which we termed {"}Pelvic Index{"} was associated to AL following sphincter-saving LAR. This may be considered in planning the surgical strategy for rectal cancer patients.",
keywords = "Anastomotic leakage, Gender, Pelvimetry, Rectal cancer, Robotic surgery, Total mesorectal excision",
author = "Emilio Bertani and Antonio Chiappa and Vigna, {Paolo Della} and Davide Radice and Davide Papis and Laura Cossu and Roberto Biffi and Bianchi, {Paolo P.} and Fabrizio Luca and Bruno Andreoni",
year = "2014",
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TY - JOUR

T1 - The impact of pelvimetry on anastomotic leakage in a consecutive series of open, laparoscopic and robotic low anterior resections with total mesorectal excision for rectal cancer

AU - Bertani, Emilio

AU - Chiappa, Antonio

AU - Vigna, Paolo Della

AU - Radice, Davide

AU - Papis, Davide

AU - Cossu, Laura

AU - Biffi, Roberto

AU - Bianchi, Paolo P.

AU - Luca, Fabrizio

AU - Andreoni, Bruno

PY - 2014

Y1 - 2014

N2 - Background/Aims: Recently, pelvic anatomy has been taken into consideration and related to surgical outcome indicators after low anterior resection (LAR). Several pelvimetric parameters have been matched with conversion rate, postoperative complications and duration of surgery in laparoscopic series, and with the quality of specimen and pathologic outcomes in further open surgical series. Methodology: In 97 consecutive patients submitted to sphincter-saving LAR with total mesorectal excision (TME) five pelvic dimensions were measured by abdominal computed tomography scan: anteroposterior and transverse diameters in the pelvic inlet (IAP and ITRA), anteroposterior and transverse diameters in the pelvic outlet (OAP and OTRA), and the pelvic depth. The endpoint evaluated was anastomotic leakage (AL) rate. Results: There were 51 open, 12 laparoscopic and 34 robotic LARs. The sum of IAP OAP and OTRA (Pelvic Index) significantly predicted AL showing that starting from the cut-point of 290 mm down to a PI of 278 mm the odds-ratio of having an AL increased from 2.63 (95% CI: 1.10,5.47) to 5.07 (95% CI: 1.35,8.02). Conclusions: The sum of the 3 pelvic dimensions which we termed "Pelvic Index" was associated to AL following sphincter-saving LAR. This may be considered in planning the surgical strategy for rectal cancer patients.

AB - Background/Aims: Recently, pelvic anatomy has been taken into consideration and related to surgical outcome indicators after low anterior resection (LAR). Several pelvimetric parameters have been matched with conversion rate, postoperative complications and duration of surgery in laparoscopic series, and with the quality of specimen and pathologic outcomes in further open surgical series. Methodology: In 97 consecutive patients submitted to sphincter-saving LAR with total mesorectal excision (TME) five pelvic dimensions were measured by abdominal computed tomography scan: anteroposterior and transverse diameters in the pelvic inlet (IAP and ITRA), anteroposterior and transverse diameters in the pelvic outlet (OAP and OTRA), and the pelvic depth. The endpoint evaluated was anastomotic leakage (AL) rate. Results: There were 51 open, 12 laparoscopic and 34 robotic LARs. The sum of IAP OAP and OTRA (Pelvic Index) significantly predicted AL showing that starting from the cut-point of 290 mm down to a PI of 278 mm the odds-ratio of having an AL increased from 2.63 (95% CI: 1.10,5.47) to 5.07 (95% CI: 1.35,8.02). Conclusions: The sum of the 3 pelvic dimensions which we termed "Pelvic Index" was associated to AL following sphincter-saving LAR. This may be considered in planning the surgical strategy for rectal cancer patients.

KW - Anastomotic leakage

KW - Gender

KW - Pelvimetry

KW - Rectal cancer

KW - Robotic surgery

KW - Total mesorectal excision

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