[MRI-based prognostic factors predicting surgical complexity in rectal cancer]

Colorectal cancer is one of the most prevalent oncological diseases, with rectal cancer accounting for a substantial proportion of cases. Surgical intervention remains the cornerstone of treatment, with its success significantly influenced by individual pelvic anatomy. Nevertheless, there is a notable scarcity of studies specifically focused on evaluating surgical complexity based on pelvic MRI pelvimetry.

To identify the prognostic factors of pelvic MRI pelviometry that affect the complexity of surgical treatment of rectal tumors.

A retrospective analysis was conducted on 28 patients with tumors of the rectum and rectosigmoid junction who underwent surgery at the University Clinic of the MNOI of Lomonosov Moscow State University between 2022 and 2024. Surgical complexity was assessed based on operative time, blood loss, conversion rate, ureteral injury, and anastomotic leakage. Correlations between these parameters and MRI pelvimetry data were analyzed.

The mean operative time was 262±85 minutes, with a mean blood loss of 161±240 mL. Ureteral injuries and conversions were observed in 7.1% of cases (2 each), and anastomotic leakage occurred in 10.7% (3 cases). Significant correlations were found between operative time and intertuberous (r=-0.55; p<0.05) and interspinous distances (r=-0.46; p<0.05), as well as sacrococcygeal distance (r=0.48; p<0.05), anorectal angle (r=0.46; p<0.05), and tumor size (r=0.39; p<0.05).

Several MRI pelvimetry parameters of the pelvis were significantly correlated with surgical complexity in rectal cancer. Preoperative evaluation of these parameters may improve surgical planning and outcomes.