Defining pelvic factors in sphincter-preservation of low rectal cancer with a three-dimensional digital model of pelvis.
OBJECTIVE
Surgeons often can contribute failure of sphincter-preserving procedure to a limitation of pelvis anatomy; however, they cannot determine definitely which anatomic diameter or spatial factor actually affected the success of the procedure.


METHODS
Colorectal surgeons, radiologists, and research fellows collaborated closely to establish a three-dimensional digital model of the pelvis with spiral computerized tomography scanning data of patients with rectal cancer. Retrospective analysis on data of 97 patients with low rectal cancer was performed with this model to identify geometric factors that might affect a successful sphincter preservation procedure for low rectal cancer.


RESULTS
A digital pelvic model was established. Multivariate analysis demonstrated that distance from the anal verge, body mass index, and pelvic factors affected the success of sphincter preservation. Sphincter preservation was more likely to succeed when the distance from anal verge was > or =5 cm and body mass index was <25 kg/m(2). Shorter diameter from the upper pubis to the sacrococcyx, distance of sacrococcyx, and excessive curvature of the sacrum predicted failure of sphincter preservation in certain cases.


CONCLUSIONS
Pelvic diameters could affect the success of sphincter preservation for low rectal cancer patients besides the distance from anal verge and body mass index.
Gu
Jin
J
Department of Surgery, School of Oncology, Peking University, Beijing 100036, China.
Bo
Xue Feng
XF
Xiong
Chun Yang
CY
Wu
Ai Wen
AW
Zhang
Xiao Peng
XP
Li
Ming
M
An
Qi
Q
Fang
Jing
J
Li
Jie
J
Zhang
Xuan
X
Wang
Hong Yi
HY
Gao
Fei
F
You
Wei Cheng
WC
D001003:Anal Canal / Q000601:surgery*; D015992:Body Mass Index; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016015:Logistic Models; D008953:Models, Anatomic; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010388:Pelvis / Q000033:anatomy & histology*; D012004:Rectal Neoplasms / Q000601:surgery*; D036542:Tomography, Spiral Computed; D017211:Treatment Failure