Applications of computed tomography pelvimetry and clinical-pathological parameters in sphincter preservation of mid-low rectal cancer.
BACKGROUND
This study aims to evaluate the predictive value of pelvic anatomical and clinical-pathological parameters that influence the success of sphincter preservation procedure (SPP).


METHODS
We studied 42 consecutive patients who underwent low anterior resection (LAR) with double stapling technique (DST) anastomosis or abdominoperineal resection (APR) for mid-low rectal cancer between June 2009 and April 2014. The surgical procedures were performed by the same surgeon and surgical team at the Department of Surgery of Wenzhou Central Hospital. Pelvic dimensions and angles were measured using three-dimensional reconstruction of spiral computed tomography (CT) images. A number of clinical-pathological parameters were also examined. Univariate and multivariate analyses were performed to determine the predictive significance of these variables that might affect a successful SPP for mid-low rectal cancer.


RESULTS
Body mass index (BMI), distance of tumor from anal verge, and diameter of upper pubis to coccyx affected the success of SPP. It was the higher distance of tumor from anal verge, the higher BMI, and the larger diameter of upper pubis to coccyx contributed most to the success of SPP.


CONCLUSIONS
Diameter of upper pubis to coccyx is the only one of the pelvic anatomical parameters that could affect the success of SPP for mid-low rectal cancer patients. Furthermore, within the normal BMI range, higher BMI seemed to be a favorable factor for the success of SPP.
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Xiaocong
X
Zhou
Department of Radio-Chemotherapy Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang, P.R. China.
Meng
M
Su
Deparment of Clinical Pharmacy, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Keqiong
K
Hu
Deparment of Clinical Pharmacy, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Yinfa
Y
Su
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Yinghai
Y
Ye
Deparment of Radiology, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Chongquan
C
Huang
Deparment of Radiology, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Zhenlei
Z
Yu
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Xiaoyang
X
Li
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Hong
H
Zhou
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Yaozhong
Y
Ni
Deparment of Pathology, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Yi
Y
Jiang
Computed tomography; mid and low rectal cancer; pelvimetry; sphincter preservation; three-dimensional reconstruction