The anthropometric definition of the rectum is highly variable

Wasserman, Molly A.; McGee, Michael F.; Helenowski, Irene; Halverson, Amy L.; Boller, Anne Marie; Stryker, Steven J.

doi:10.1007/s00384-015-2458-5

Cited by 24 publications

(17 citation statements)

References 33 publications

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“…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 . One previous in vivo intra‐operative study found there was almost no difference in distance from the anal verge to the sigmoid take‐off with the coalescence of the taenia coli (1 cm in men, no difference in women ).…”

Section: Discussioncontrasting

confidence: 86%

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Variation in landmarks for the rectum: an MRI study

et al. 2018

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Section: Discussioncontrasting

confidence: 86%

“…We found a wide variation in the length of the rectum from 9.4 to 19 cm, which has been reported in other studies . Arbitrary landmarks will not account for this variation in patient anatomy and rectal length, and therefore frequently do not localize the rectosigmoid junction accurately.…”

Section: Discussionsupporting

confidence: 59%

Variation in landmarks for the rectum: an MRI study

et al. 2018

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“…Therefore, height was adjusted using international accepted definitions for anal verge (baseline 0 cm), dentate line (+1.9 cm) and anorectal junction (+4 cm) [21–23]. Post-operative complications were reported as classified by Clavien–Dindo [24].…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes and case volume effect of transanal total mesorectal excision for rectal cancer: a systematic review

et al. 2016

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Transanal total mesorectal excision (TaTME) has been developed to improve quality of TME for patients with mid and low rectal cancer. However, despite enthusiastic uptake and teaching facilities, concern exists for safe introduction. TaTME is a complex procedure and potentially a learning curve will hamper clinical outcome. With this systematic review, we aim to provide data regarding morbidity and safety of TaTME. A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Ovid) and Cochrane Library. Case reports, cohort series and comparative series on TaTME for rectal cancer were included. To evaluate a potential effect of case volume, low-volume centres (n ≤ 30 total volume) were compared with high-volume centres (n > 30 total volume). Thirty-three studies were identified (three case reports, 25 case series, five comparative studies), including 794 patients. Conversion was performed in 3.0% of the procedures. The complication rate was 40.3, and 11.5% were major complications. The quality of the mesorectum was “complete” in 87.6%, and the circumferential resection margin (CRM) was involved in 4.7%. In low- versus high-volume centres, the conversion rate was 4.3 versus 2.7%, and major complication rates were 12.2 versus 10.5%, respectively. TME quality was “complete” in 80.5 versus 89.7%, and CRM involvement was 4.8 and 4.5% in low- versus high-volume centres, respectively. TaTME for mid and low rectal cancer is a promising technique; however, it is associated with considerable morbidity. Safe implementation of the TaTME should include proctoring and quality assurance preferably within a trial setting.

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“…35 One problem of using a fixed cm measurements is that the individual length and distance from anal verge to anatomical landmarks varies in relation to BMI, age, gender and weight. 36 The rectum lies infra peritoneally, with the lowest peritoneal reflection in the anterior aspect, the pouch of Douglas. Below this level, between the rectum and the posterior vaginal wall or prostate in female and male respectively the Denonvilliers' fascia is found.…”

Section: Anatomymentioning

confidence: 99%