MRI-defined height of rectal tumours

Keller, Deborah S.; Paspulati, Raj Mohan; Kjellmo, Åse; Rokseth, Kjell Morten; Bankwitz, Blake; Wibe, Arne; Delaney, Conor P.

doi:10.1002/bjs.9355

Cited by 44 publications

(31 citation statements)

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“…A potential criticism of this study would be the use of MRI instead of proctoscopy to measure distance from the anal verge. However, a previous study has described the difference in heights on MRI and proctoscopy as less than 1 cm . We did not corroborate our MRI lengths with proctoscopy, although previous in vivo studies on metric measurements using rigid endoscopy have confirmed a wide variation in rectal length .…”

Section: Discussioncontrasting

confidence: 92%

Variation in landmarks for the rectum: an MRI study

et al. 2018

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Section: Discussioncontrasting

confidence: 92%

Variation in landmarks for the rectum: an MRI study

et al. 2018

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“…Eligible patients were those presenting with a tumour 15 cm or less from the anal verge measured by MRI. Patients who underwent low anterior resection for primary adenocarcinoma of the rectum with curative intent were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Oncological outcome following anastomotic leak in rectal surgery

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et al. 2015

British Journal of Surgery

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“…For the evaluated cases, all data were collected anonymously with entry as case numbers. In order to calculate the distance from the anal verge (AV) when only distance from anorectal junction was provided, the tumor distance measured from the anorectal junction was corrected by adding four centimeters for males and females [14][15][16][17]. The part of the rectum in which the tumor was situated was defined by distance from the AV as 0-6 cm, 7-11 cm, and 12-15 cm for low, mid, and high rectum, respectively [15].…”

Section: Patientsmentioning

confidence: 99%

Structured training pathway and proctoring; multicenter results of the implementation of transanal total mesorectal excision (TaTME) in the Netherlands

et al. 2019

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Background Transanal total mesorectal excision (TaTME) is a new complex technique with potential to improve the quality of surgical mesorectal excision for patients with mid and low rectal cancer. The procedure is technically challenging and has shown to be associated with a relative long learning curve which might hamper widespread adoption. Therefore, a national structured training pathway for TaTME has been set up in the Netherlands to allow safe implementation. The aim of this study was to monitor safety and efficacy of the training program with 12 centers. Methods Short-term outcomes of the first ten TaTME procedures were evaluated in 12 participating centers in the Netherlands within the national structured training pathway. Consecutive patients operated during and after the proctoring program for rectal carcinoma with curative intent were included. Primary outcome was the incidence of intraoperative complications, secondary outcomes included postoperative complications and pathological outcomes. Results In October 2018, 12 hospitals completed the training program and from each center the first 10 patients were included for evaluation. Intraoperative complications occurred in 4.9% of the cases. The clinicopathological outcome reported 100% for complete or nearly complete specimen, 100% negative distal resection margin, and the circumferential resection margin was positive in 5.0% of patients. Overall postoperative complication rate was 45.0%, with 19.2% Clavien-Dindo ≥ III and an anastomotic leak rate of 17.3%. Conclusions This study shows that the nationwide structured training program for TaTME delivers safe implementation of TaTME in terms of intraoperative and pathology outcomes within the first ten consecutive cases in each center. However, postoperative morbidity is substantial even within a structured training pathway and surgeons should be aware of the learning curve of this new technique.Keywords TaTME · TAMIS · Rectal cancer · Proctoring · Training Transanal total mesorectal excision (TaTME) has been proposed as a potentially better alternative to the laparoscopic standard TME for mid and distal rectal cancer [1][2][3][4]. The bottom-up approach for the deep pelvic region increases exposure and facilitates the distal mesorectal excision. Especially those difficult cases such as obese patients, low rectal and Other Interventional Techniques Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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MRI-defined height of rectal tumours

Abstract: There was up to 5.5 cm variation, depending on which landmark was chosen for reporting the distal margin of rectal cancer. This has potential implications for surgical planning, interpreting radiological images and comparative studies.

Cited by 44 publications

References 25 publications

Variation in landmarks for the rectum: an MRI study

Variation in landmarks for the rectum: an MRI study

Oncological outcome following anastomotic leak in rectal surgery

Structured training pathway and proctoring; multicenter results of the implementation of transanal total mesorectal excision (TaTME) in the Netherlands

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