Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer

Introduction: Despite a lack of a well-defined concept of ‘pelvic difficulties’, pelvimetric parameters significantly influence surgical difficulty and outcomes in mid-low rectal cancer (MLRC). Aim: The objective of this study was to explore the influence of pelvimetric parameters and surgical ap...

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Main Authors: Jie Wang, Dengyang Fang, Ruiqi Li, Yifan Cheng, Shuai Zhao, Jiajie Zhou, Zhen Tian, Chenkai Zhang, Yayan Fu, Yong Wang, Jun Ren, Daorong Wang
Format: Article
Language:English
Published: Medycyna Praktyczna 2025-07-01
Series:Videosurgery and Other Miniinvasive Techniques
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Online Access:https://www.mp.pl/videosurgery/issue/article/17962/
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author Jie Wang
Dengyang Fang
Ruiqi Li
Yifan Cheng
Shuai Zhao
Jiajie Zhou
Zhen Tian
Chenkai Zhang
Yayan Fu
Yong Wang
Jun Ren
Daorong Wang
author_facet Jie Wang
Dengyang Fang
Ruiqi Li
Yifan Cheng
Shuai Zhao
Jiajie Zhou
Zhen Tian
Chenkai Zhang
Yayan Fu
Yong Wang
Jun Ren
Daorong Wang
author_sort Jie Wang
collection DOAJ
description Introduction: Despite a lack of a well-defined concept of ‘pelvic difficulties’, pelvimetric parameters significantly influence surgical difficulty and outcomes in mid-low rectal cancer (MLRC). Aim: The objective of this study was to explore the influence of pelvimetric parameters and surgical approaches on the difficulty of surgical procedures in MLRC. Materials and methods: A retrospective analysis was performed at the Northern Jiangsu People’s Hospital, including patients with a diagnosis of MLRC who underwent total mesorectal excision between January 2016 and June 2023. We analyzed the pelvimetric parameters and perioperative data. Results: The study cohort comprised a total of 1138 individuals. Based on the surgical difficulty score, 374 patients were assigned to the difficult surgery (DS) group, and 764, to the non-difficult surgery group. Patients in the DS group were stratified into 2 groups based on the surgical approach: the robot-assisted laparoscopic surgery (RLS) group with 78 patients, and the conventional laparoscopic surgery group, including 296 patients. Multivariable analysis results showed that age, sex, pelvic inlet anteroposterior diameters (PIAPD), pubic symphysis height, pelvic depth, and angle A were independent influencing factors for DS. Conclusions: Age, sex, PIAPD, pubic symphysis height, pelvic depth, and angle A were independent factors influencing DS in MLRC. In the DS group patients, RLS had certain advantages.
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spelling doaj-art-0c977a6c217e403d974c78fa536e504a2025-08-20T03:14:10ZengMedycyna PraktycznaVideosurgery and Other Miniinvasive Techniques1895-45882299-00542025-07-01216517110.20452/wiitm.2025.17962Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancerJie Wang0Dengyang Fang1Ruiqi Li2Yifan Cheng3 Shuai Zhao4Jiajie Zhou5Zhen Tian6Chenkai Zhang7Yayan Fu8Yong Wang9Jun Ren10Daorong Wang11Northern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China; Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China; Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, ChinaNorthern Jiangsu People’s Hospital Affiliated with Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China; Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, China; Northern Jiangsu People’s Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Yangzhou, Jiangsu, China; Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, Jiangsu, China; General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, Jiangsu, ChinaIntroduction: Despite a lack of a well-defined concept of ‘pelvic difficulties’, pelvimetric parameters significantly influence surgical difficulty and outcomes in mid-low rectal cancer (MLRC). Aim: The objective of this study was to explore the influence of pelvimetric parameters and surgical approaches on the difficulty of surgical procedures in MLRC. Materials and methods: A retrospective analysis was performed at the Northern Jiangsu People’s Hospital, including patients with a diagnosis of MLRC who underwent total mesorectal excision between January 2016 and June 2023. We analyzed the pelvimetric parameters and perioperative data. Results: The study cohort comprised a total of 1138 individuals. Based on the surgical difficulty score, 374 patients were assigned to the difficult surgery (DS) group, and 764, to the non-difficult surgery group. Patients in the DS group were stratified into 2 groups based on the surgical approach: the robot-assisted laparoscopic surgery (RLS) group with 78 patients, and the conventional laparoscopic surgery group, including 296 patients. Multivariable analysis results showed that age, sex, pelvic inlet anteroposterior diameters (PIAPD), pubic symphysis height, pelvic depth, and angle A were independent influencing factors for DS. Conclusions: Age, sex, PIAPD, pubic symphysis height, pelvic depth, and angle A were independent factors influencing DS in MLRC. In the DS group patients, RLS had certain advantages.https://www.mp.pl/videosurgery/issue/article/17962/aparoscopicmid‑low rectal cancerpelvimetric parametersroboticsurgical difficulty
spellingShingle Jie Wang
Dengyang Fang
Ruiqi Li
Yifan Cheng
Shuai Zhao
Jiajie Zhou
Zhen Tian
Chenkai Zhang
Yayan Fu
Yong Wang
Jun Ren
Daorong Wang
Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
Videosurgery and Other Miniinvasive Techniques
aparoscopic
mid‑low rectal cancer
pelvimetric parameters
robotic
surgical difficulty
title Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
title_full Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
title_fullStr Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
title_full_unstemmed Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
title_short Influence of computed tomography–based pelvimetric parameters and surgical approaches on surgical difficulty in mid‑low rectal cancer
title_sort influence of computed tomography based pelvimetric parameters and surgical approaches on surgical difficulty in mid low rectal cancer
topic aparoscopic
mid‑low rectal cancer
pelvimetric parameters
robotic
surgical difficulty
url https://www.mp.pl/videosurgery/issue/article/17962/
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