Impact of pelvic dimensions on anastomotic leak after anterior resection for patients with rectal cancer

Yu, Zhaoliang; Liu, Xuanhui; Liu, Huashan; Ke, Jia; Zou, Yifeng; Cao, Wuteng; Xiao, Jian; Zhou, Zhiyang; Lan, Ping; Wu, Xiaojian; Wu, Xianrui

doi:10.1007/s00464-020-07617-1

Cited by 11 publications

(16 citation statements)

References 28 publications

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“…While the sex difference in anastomotic leakage has long been known, the literature is surprisingly devoid of studies evaluating possible causes. Disparities in rectal cancer surgery are not explained by differing pelvic dimensions [ 4 ], and leak rates are higher in men even in colon cancer operations [ 3 ]. While experimental data point to biological differences regarding e.g.…”

Section: Discussionmentioning

confidence: 99%

“…In rectal cancer specifically, the lower leak rates in women have been explained by a technically easier dissection, due to a wider pelvis. Recent pelvimetric studies have however shown that, despite an association between larger pelvic inlet and outlet and leakage, male sex remains an independent risk factor for leakage [ 4 ]. Moreover, this sex‐specific effect also exists in colon cancer surgery, possibly due to dissimilarities in visceral fat distribution [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Exposure to oestrogen and risk of anastomotic leakage after colorectal cancer surgery – A clue to the different leak rates in men and women

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exposure to oestrogen and risk of anastomotic leakage after colorectal cancer surgery – A clue to the different leak rates in men and women

et al. 2022

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“…Interspinous distance corresponded to the transverse distance between the tips of ischial spines, assessed on the axial plane ( Figure 2C , line 5). Intertuberous distance corresponded to the transverse distance between the lowest points of ischial tuberosities, assessed on the axial plane ( Figure 2D , line 6) ( 12 , 18 , 28 – 30 ).…”

Section: Methodsmentioning

confidence: 99%

An MRI-based pelvimetry nomogram for predicting surgical difficulty of transabdominal resection in patients with middle and low rectal cancer

et al. 2022

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ObjectiveThe current work aimed to develop a nomogram comprised of MRI-based pelvimetry and clinical factors for predicting the difficulty of rectal surgery for middle and low rectal cancer (RC).MethodsConsecutive mid to low RC cases who underwent transabdominal resection between June 2020 and August 2021 were retrospectively enrolled. Univariable and multivariable logistic regression analyses were carried out for identifying factors (clinical factors and MRI-based pelvimetry parameters) independently associated with the difficulty level of rectal surgery. A nomogram model was established with the selected parameters for predicting the probability of high surgical difficulty. The predictive ability of the nomogram model was assessed by the receiver operating characteristic (ROC) curve and decision curve analysis (DCA).ResultsA total of 122 cases were included. BMI (OR = 1.269, p = 0.006), pelvic inlet (OR = 1.057, p = 0.024) and intertuberous distance (OR = 0.938, p = 0.001) independently predicted surgical difficulty level in multivariate logistic regression analysis. The nomogram model combining these predictors had an area under the ROC curve (AUC) of 0.801 (95% CI: 0.719–0.868) for the prediction of a high level of surgical difficulty. The DCA suggested that using the nomogram to predict surgical difficulty provided a clinical benefit.ConclusionsThe nomogram model is feasible for predicting the difficulty level of rectal surgery, utilizing MRI-based pelvimetry parameters and clinical factors in mid to low RC cases.

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“…Novel evidence suggests that pelvic dimensions, particularly pelvic inlet and intertuberous distance, were associated with an increased risk of developing AL after anterior resection [ 18 ]. In addition, Verduin et al [ 19 ] revealed that the previously mentioned correlations of male gender and BMI with AL after colon cancer resection were attributed to the visceral fat.…”

Section: Risk Factors For Anastomotic Leakagementioning

confidence: 99%

Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?

et al. 2023

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Anastomotic leakage (AL) remains one of the most severe complications following colorectal cancer (CRC) surgery. Indeed, leaks that may occur after any type of intestinal anastomosis are commonly associated with a higher reoperation rate and an increased risk of postoperative morbidity and mortality. At first, our review aims to identify specific preoperative, intraoperative and perioperative factors that eventually lead to the development of anastomotic dehiscence based on the current literature. We will also investigate the role of several biomarkers in predicting the presence of ALs following colorectal surgery. Despite significant improvements in perioperative care, advances in surgical techniques, and a high index of suspicion of this complication, the incidence of AL remained stable during the last decades. Thus, gaining a better knowledge of the risk factors that influence the AL rates may help identify high-risk surgical patients requiring more intensive perioperative surveillance. Furthermore, prompt diagnosis of this severe complication may help improve patient survival. To date, several studies have identified predictive biomarkers of ALs, which are most commonly associated with the inflammatory response to colorectal surgery. Interestingly, early diagnosis and evaluation of the severity of this complication may offer a significant opportunity to guide clinical judgement and decision-making.

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Impact of pelvic dimensions on anastomotic leak after anterior resection for patients with rectal cancer

Cited by 11 publications

References 28 publications

Exposure to oestrogen and risk of anastomotic leakage after colorectal cancer surgery – A clue to the different leak rates in men and women

Exposure to oestrogen and risk of anastomotic leakage after colorectal cancer surgery – A clue to the different leak rates in men and women

An MRI-based pelvimetry nomogram for predicting surgical difficulty of transabdominal resection in patients with middle and low rectal cancer

Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?

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