title: Gender differences in pelvic anatomy and effects on rectal cancer surgery.
abstract: 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.
authors.affiliation: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. kseike-cib@umin.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seike
authors.forename: Keiji
authors.initials: K
authors.lastname: Koda
authors.forename: Kenji
authors.initials: K
authors.lastname: Oda
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kosugi
authors.forename: Kimio
authors.initials: K
authors.lastname: Shimizu
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: 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