[Computed tomography pelvimetry as a predictor of technical difficulty in total mesorectal excision]

Area of Science:

• Surgical Oncology
• Radiology
• Anatomy

Background:

• Total mesorectal excision (TME) is a standard surgical procedure for rectal cancer.
• Pelvic anatomy can influence surgical approach and outcomes.
• Predicting surgical difficulty is crucial for patient management.

Purpose of the Study:

• To assess the influence of pelvic dimensions on the technical difficulty of TME.
• To identify specific pelvic parameters that predict operative time and blood loss.
• To correlate computed tomography pelvimetry findings with TME outcomes.

Main Methods:

• Retrospective analysis of 69 rectal cancer patients undergoing TME.
• Measurement of 15 pelvic parameters using 3D reconstruction software from MDCT scans.
• Correlation of pelvic dimensions with operative time and intraoperative blood loss via univariate and multivariate analyses.

Main Results:

• Interspinous distance, pelvic inlet length, and sacrum-coccyx distance affected operative time.
• Pubic symphysis length and sacrum-coccyx distance influenced blood loss.
• A specific ratio of pelvic inlet length to sacrum-coccyx distance predicted operative time and blood loss, with variations between sexes.

Conclusions:

• Pelvic dimensions, particularly inlet and sacrum-coccyx measurements, predict TME difficulty.
• Wider pelves are associated with more favorable operative outcomes.
• Computed tomography pelvimetry can preoperatively assess surgical risk for TME.