Using CT-Based Pelvimetry and Visceral Obesity Measurements to Predict Total Mesorectal Excision Quality for Patients...

Area of Science:

• Surgical Oncology
• Radiology
• Pelvic Anatomy

Background:

• Complete total mesorectal excision (TME) is the gold standard for curative rectal cancer surgery.
• Surgical quality is compromised in narrow pelves and by obesity, increasing technical difficulty.
• The predictive role of pelvimetry for proctectomy difficulty remains largely unexplored.

Purpose of the Study:

• To identify pelvic structural factors predicting incomplete TME after curative proctectomy.
• To develop a predictive model for assessing TME quality preoperatively.

Main Methods:

• Retrospective cohort study of rectal adenocarcinoma patients (2009-2017).
• Preoperative CT scans were used for radiological pelvimetry measurements.
• TME completeness was determined from histological reports.

Main Results:

• A deeper sacral curve and wider transverse pelvic outlet distance were associated with incomplete TME.
• A larger pelvic inlet area correlated with a higher rate of complete TME.
• No significant association was found between visceral obesity and TME quality based on BMI or sex.

Conclusions:

• Pelvimetry effectively predicts TME quality in rectal cancer surgery.
• Preoperative pelvimetry can identify patients with potentially difficult proctectomies.
• The developed predictive model can inform treatment strategies and outcome comparisons.