Gender differences in pelvic anatomy and effects on rectal cancer surgery.
OBJECTIVE
The male pelvis is said to be narrower and deeper than the female pelvis. The present study aimed to evaluate anatomical differences in the pelvis between genders, and to analyze effects on rectal cancer surgery.


METHODS
Gender differences in pelvic anatomy were evaluated using computed tomography in 78 Japanese patients who had received low anterior resection for rectal cancer. Factors affecting operative duration and intraoperative blood loss were analyzed for both low anterior resection and ultra-low anterior resection.


RESULTS
Pelvic capacity was significantly lower in males (460.0 +/- 16.7 cm3) than in females (634.8 +/- 22.0 cm3; p < 0.0001), and level of the levator ani compared to the upper edge of the pubis was significantly lower in males than in females. Surgical parameters in ultra-low anterior resection were affected by level of the levator ani, tumor volume and tumor height compared to the upper edge of the pubis, not by tumor height above anal verge.


CONCLUSIONS
The pelvis was narrower and deeper in males than in females. Obtaining good visualization is critical particularly in performing ultra-low anterior resection against a large tumor located below the upper edge of the pubis in a patient who has deep pelvic floor.
Seike
Kazuhiro
K
Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. kseike-cib@umin.ac.jp
Koda
Keiji
K
Oda
Kenji
K
Kosugi
Chihiro
C
Shimizu
Kimio
K
Miyazaki
Masaru
M
D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome