title: The Impact of pelvimetry on anastomotic leakage in a consecutive series of open, laparoscopic and robotic low anterior resections with total mesorectal excision for rectal cancer. .
abstract: OBJECTIVE
  Recently, pelvic anatomy has been taken into consideration and related to surgical outcome indicators after low anterior resection (LAR). Several pelvimetric parameters have been matched with conversion rate, postoperative complications and duration of surgery in laparoscopic series, and with the quality of specimen and pathologic outcomes in further open surgical series.
  
  
  METHODS
  In 97 consecutive patients submitted to sphincter-saving LAR with total mesorectal excision (TME) five pelvic dimensions were measured by abdominal computed tomography scan: anteroposterior and transverse diameters in the pelvic inlet (IAP and ITRA), anteroposterior and transverse diameters in the pelvic outlet (OAP and OTRA), and the pelvic depth. The endpoint evaluated was anastomotic leakage (AL) rate.
  
  
  RESULTS
  There were 51 open, 12 laparoscopic and 34 robotic LARs. The sum of IAP OAP and OTRA (Pelvic Index) significantly predicted AL showing that starting from the cut-point of 290 mm down to a PI of 278 mm the odds-ratio of having an AL increased from 2.63 (95% CI: 1.10,5.47) to 5.07 (95% CI: 1.35,8.02).
  
  
  CONCLUSIONS
  The sum of the 3 pelvic dimensions which we termed “Pelvic Index” was associated to AL following sphinctersaving LAR. This may be considered in planning the surgical strategy for rectal cancer patients.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Vigna
authors.forename: Davide
authors.initials: D
authors.lastname: Radice
authors.forename: Davide
authors.initials: D
authors.lastname: Papis
authors.forename: Laura
authors.initials: L
authors.lastname: Cossu
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Paolo P
authors.initials: PP
authors.lastname: Bianchi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Luca
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology*; D059925:Anatomic Landmarks; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010387:Pelvimetry / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012371:Robotics; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome