Abstract:
BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on surgical specimen quality. METHODS:We performed a retrospective analysis of a prospectively maintained database of patients who had resection for rectal cancer from January 2014 to December 2017. Preoperative magnetic resonance imaging (MRI) and computed tomography (CT) images were accessed and measurements of sacrococcygeal distance, sacrococcygeal recess depth/area, sacrococcygeal angulation, anteroposterior pelvic inlet/outlet, pubic height and interspinous distance were made. Outcome measures included anatomical variation, operating time and mesorectal specimen grade. In patients having extra-levator abdominoperineal excision (eLAPE) with coccygectomy, the completeness of coccygeal resection was assessed by postoperative CT scan. Data were analysed using binomial and multinomial logistic regression and linear regression. RESULTS:One hundred and twenty-two consecutive rectal cancer resections were performed (39 open, 42 laparoscopic, 12 laparoscopic-converted and 29 robotic). The median age was 72 years (range: 29-88 years). The male:female ratio was 83:39. Eighty-one patients had anterior resection, 8 had low Hartmann's resection and 32 had APE. Of those who had APE, 21 had eLAPE (all with coccygectomy). Females had a larger pelvic inlet (female: 124.9 mm, male: 114.9 mm), interspinous diameter(female:112.8 mm, male:97.6 mm), sacrococcygeal depth (female:42.6 mm, 39.35 mm) and sacrococcygeal area recess than males (female: 3697 mm2, male: 3481.5 mm2). Males had a greater pubic height (female: 51.8 mm, male: 54.05 mm) and greater sacrococcygeal distance (female: 116.7 mm, male: 123.65 mm) than females. In patients having anterior resection, tumour distance from the anal verge (p = 0.004), sacrococcygeal distance (p = 0.006) and sacrococcygeal curvature (p = 0.002) were associated with specimen quality. In patients who had eLAPE, median preoperative coccygeal length was 41 mm (IQR: 35.1-45.5). The median length of coccygeal resection was 9 mm (IQR: 1-17.45 mm). The median length of coccyx remaining postoperatively was 33 mm (IQR: 21.35-39 mm). CONCLUSIONS:Sacrococcygeal curvature and distance as well as tumour distance from the anal margin were associated with specimen quality in anterior resection. Coccygectomy was not performed as completely as surgeons thought. Surgeons should include sacrococcygeal bony anatomy in rectal cancer surgical planning to potentially improve outcomes in both anterior resection and eLAPE approaches.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Simpson G,Marks T,Blacker S,Smith D,Walsh Cdoi
10.1007/s10151-020-02273-ysubject
Has Abstractpub_date
2020-10-01 00:00:00pages
1063-1070issue
10eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-020-02273-yjournal_volume
24pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to assess the long-term outcomes of laparoscopic rectopexy for full-thickness rectal prolapse (FTRP). METHODS:Data of a prospectively maintained database were analysed. A structured telephone interview was conducted to assess a consecutive series of long-term outcomes of an unselec...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-018-1913-z
更新日期:2019-01-01 00:00:00
abstract::This technical note presents a variation of the stapled mucosal prolapsectomy for haemorrhoidal prolapse using the Lone Star Retractor. Our experience highlights the simplicity and usefulness of the technique which is based on the complete eversion of the prolapse carried out by the Lone Star Retractor, without using ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/pl00012123
更新日期:2001-04-01 00:00:00
abstract:INTRODUCTION:One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases. METHOD:A literature review of MEDLINE, Cochrane and Google s...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0888-4
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Anal pain is a well-known sequel of rubber band ligation (RBL). A plastic device, the anal cooler which can be frozen in a freezer, has been developed to reduce anal pain. It contains a mixture of glycols and has a minimum temperature of 4 °C. This study was designed to investigate the efficacy of the anal c...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10151-012-0824-7
更新日期:2012-06-01 00:00:00
abstract::Despite improvements in medical therapy, the annual high mortality rate from end-stage heart failure continues. Although cardiac transplantation is a successful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD) technology is applied to a ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0365-7
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Technical feasibility of inferior rectal nerve anastomosis to the anterior vagus branch of the perineally transposed antropyloric valve for total anorectal reconstruction has been previously demonstrated in cadavers. To the best of our knowledge, the present study is the first report of using this procedure ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1092-x
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Patient self-report is important in the assessment of the impact of anal incontinence (AI) on quality of life. This study aimed to (1) determine the correlation between total St. Mark's Incontinence Score (SMIS) and a single-item visual analogue scale (VAS) for bother from AI, and (2) determine the correlati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-015-1397-z
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Conventional abdominoperineal excision (APE) of the rectum is associated with higher circumferential resection margin (CRM) involvement, increased local recurrence, and reduced survival compared to anterior resection. A more radical extralevator APE (ELAPE) technique may improve oncological outcome. However,...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0851-4
更新日期:2012-10-01 00:00:00
abstract::Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The diagnosis and management can present a significant challenge due to delayed presentation and the reluctance of the patients to provide details of the incident. The aim of the clinical evaluation is to id...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0899-1
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. PATIENTS AND METHODS:Three hundred and seven patients underwent a potentially curative resection for colorectal cance...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0117-x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Fibre is often recommended as the first-choice treatment but its effects can be uneven. The aim of the study was to compare the clinical efficacy and tolerability of fibre versus lactulose in outpatients with chronic constipation. METHODS:In a prospective randomized crossover trial, patients were randomized...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10151-006-0262-5
更新日期:2006-07-01 00:00:00
abstract::Anal fissure management has rapidly progressed in the last 15 years as our understanding of fissure pathophysiology has developed. All methods of treatment aim to reduce the anal sphincter spasm associated with chronic anal fissures. Surgical techniques have been used for over 100 years with success. Lateral internal ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-007-0355-9
更新日期:2007-09-01 00:00:00
abstract::Prolapse is a common complication in patients with a transverse loop colostomy. In most cases, the prolapse can be managed conservatively awaiting time for closure eventually. However, loop stoma may also be intentionally permanent or the patient may be too fragile to have the colostomy closed and in these cases a lap...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0051-y
更新日期:2004-03-01 00:00:00
abstract::Hepatic resection for colorectal liver metastases remains the only therapeutic option that improves long-term survival and offers potential cure. By conventional resectability criteria, only a limited number of patients with metastatic disease can be subjected to surgical intervention. In the past decade, better under...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0750-0
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:In theory, perioperative detection of lymph nodes with the injection of isosulfan blue dye should provide lymph road mapping (LRM) able to direct the resection. However, there is no supporting evidence for this theory in cases of colon cancer. We reanalysed all operative reports using the sentinel lymph node...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0603-2
更新日期:2010-09-01 00:00:00
abstract::We report the case of a pelvic and lower abdomen crushing trauma in 37-year-old male patient. The patient had an open lumbar wound, laceration of the psoas muscle, pelvic fracture, a ruptured urogenital diaphragm, and extensive urogenital lacerations. An emergency laparotomy was performed with debridment, urethral rec...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0680-x
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:Introduction of stapled hemorrhoidopexy (SH) brought a radical change in the treatment of haemorrhoidal disease. The aim of this study is to evaluate the results and the complications (early and late) from the use of this technique. METHODS:During the last 6 years (2005-2011), 123 patients underwent a SH in ou...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0739-8
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Doppler-guided hemorrhoidal artery ligation (DGHAL) was described as lower risk and a less painful alternative to hemorrhoidectomy. We report our experience and 5-year follow-up with this procedure. METHODS:Between May 2003 and December 2004, 100 patients with symptomatic Grade II or III hemorrhoids underwe...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0801-6
更新日期:2012-02-01 00:00:00
abstract:PURPOSE:Sacral neuromodulation has been reported as a treatment for severe idiopathic constipation. This study aimed to evaluate the long-term effects of sacral neuromodulation by following patients who participated in a prospective, open-label, multicentre study up to 5 years. METHODS:Patients were followed up at 1, ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-017-1613-0
更新日期:2017-04-01 00:00:00
abstract::Unfortunately, the 2nd affiliation of Dr. M. Shalaby has been missed out in the original publication. The complete 2nd affiliation of the same is given below. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,已发布勘误
doi:10.1007/s10151-018-1868-0
更新日期:2018-10-01 00:00:00
abstract::Guidelines for the treatment of anal fissure have been published in the USA and UK but differ. Many centers follow guidelines based on local experience. In December 2005, we met with the aim of developing an evidence-based treatment algorithm for anal fissure, applicable to both primary and secondary care. This algori...
journal_title:Techniques in coloproctology
pub_type: 共识发展会议,杂志文章
doi:10.1007/s10151-006-0276-z
更新日期:2006-10-01 00:00:00
abstract::Because of its technical difficulty, totally laparoscopic right colectomy with intracorporeal anastomosis is performed only by a small number of surgeons and most of them use a laparoscopic-assisted technique with extracorporeal anastomosis. This systematic review aims to evaluate differences in outcomes of patients u...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10151-013-1029-4
更新日期:2014-01-01 00:00:00
abstract::Transanal advancement flap repair (TAFR) has been advocated as the treatment of choice for patients with low rectovaginal fistulas. Recently, several studies have reported a significantly lower healing rate. We also encountered low healing rates after TAFR. In an attempt to improve our results, we added labial fat fla...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s101510200007
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Extralevator abdominoperineal excision (ELAPE) probably improves the oncological quality of low rectal cancer surgery, as compared to standard abdominoperineal excision (SAPE), possibly due to lower rates of accidental perioperative bowel perforations and lower rates of circumferential resection margin (CRM)...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1243-8
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:The quantitative immunochemical faecal occult blood test (qFOBT) has been shown to be an accurate method of identifying significant colorectal neoplasia including cancer and advanced adenomas. This study reports the results of a Singapore population-based colorectal cancer screening event using the qFOBT. M...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0515-1
更新日期:2009-09-01 00:00:00
abstract::The purpose of this systematic review was to compare the diagnostic ability of blood markers for colorectal cancer (CRC). A systematic review of the literature for diagnostic blood markers for primary human colorectal cancer over the last 5 years was performed. The primary outcome was to assess the diagnostic ability ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-018-1820-3
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Representatives from the Italian centers experienced in sacral neuromodulation (SNM) for the treatment of bowel dysfunction met in order to define the current clinical practice in Italy and to produce a consensus statement regarding indications for this therapy and patient management. METHODS:Fifty Italian ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1002-2
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the role of confocal laser endomicroscopy (CLE) in the assessment of disease activity in ulcerative colitis (UC). METHODS:Consecutive patients with UC referred to our inflammatory bowel disease unit for colonoscopy were enrolled. Patients without UC were used as cont...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1654-4
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Early detection of colorectal anastomotic leakage (AL) may lead to better outcome. AL may be preceded by change in local metabolism and local ischaemia. Microdialysis of the peritoneal cavity is able to measure these changes in real-time and is minimally invasive. The aim of this prospective cohort study was...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1020-0
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:This study was designed to assess defecatory function in patients who underwent laparoscopic ventral rectopexy (LVR) for external rectal prolapse (ERP). METHODS:Thirty-one patients who underwent evacuation proctography 6 months postoperatively were assessed. Preoperative proctography had been performed in 2...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-015-1395-1
更新日期:2016-02-01 00:00:00