Mesorectal fat area as a useful predictor of the difficulty of robotic-assisted laparoscopic total mesorectal excision for rectal cancer

Surgical Endoscopy
Yusuke YamaokaKeita Mori

Abstract

Various predictors of the difficulty of total mesorectal excision for rectal cancer have been described. Although a bulky mesorectum was considered to pose technical difficulties in total mesorectal excision, no studies have evaluated the influence of mesorectum morphology on the difficulty of total mesorectal excision. Mesorectal fat area at the level of the tip of the ischial spines on magnetic resonance imaging was described as a parameter characterizing mesorectum morphology. This study aimed to evaluate the influence of clinical and anatomical factors, including mesorectal fat area, on the difficulty of total mesorectal excision for rectal cancer. This study enrolled 98 patients who underwent robotic-assisted laparoscopic low anterior resection with total mesorectal excision for primary rectal cancer, performed by a single expert surgeon, between 2010 and 2015. Magnetic resonance imaging-based pelvimetry data were collected. Linear regression was performed to determine clinical and anatomical factors significantly associated with operative time of the pelvic phase, which was defined as the time interval from the start of rectal mobilization to the division of the rectum. The median operative time of the pelvic phase was 68...Continue Reading

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Citations

Feb 11, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Shenghui HuangPan Chi
Jul 12, 2019·Journal of Surgical Oncology·Bradley R HallBradley N Reames
Nov 25, 2020·International Journal of Colorectal Disease·Laura LorenzonElsa Iannicelli
Aug 3, 2021·International Journal of Colorectal Disease·Jonathan S Y HongMichael J Solomon

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