title: Prediction of Anastomotic Leakage After Laparoscopic Low Anterior Resection in Male Rectal Cancer by Pelvic Measurement in Magnetic Resonance Imaging.
abstract: OBJECTIVE
  Anastomotic leakage after laparoscopic low anterior resection in male rectal cancer patients with a narrow pelvis cannot be easily resolved. The objective of this study is to assess numerical information of narrow pelvis and to determine whether prediction of morbidity can be possible.
  
  
  METHODS
  Retrospective medical record review was performed. From July 2007 to January 2013, 43 consecutive male patients with low rectal cancer who underwent laparoscopic low anterior resection were divided into the anastomotic leakage-negative group and anastomotic leakage-positive group. Eleven anatomic parameters were measured from preoperative magnetic resonance imaging of pelvis and a new index called "pelvic index" was calculated.
  
  
  RESULTS
  The pelvic index (difference between the interspinous distance and the diameter of the mesorectum divided by the depth of the cavity of the lesser pelvis) in the leakage-positive group was significantly smaller than that in the negative group (P=0.038). Comparison between those 2 groups at the border of the cut-off value of the pelvic index (13.0) showed a significant difference.
  
  
  CONCLUSIONS
  Preoperative assessment by the pelvic index can predict the narrow pelvis and risk of anastomotic leakage.
authors.affiliation: *Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Okayama †Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tsuruta
authors.forename: Jo
authors.initials: J
authors.lastname: Tashiro
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Ishii
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Oka
authors.forename: Asami
authors.initials: A
authors.lastname: Suzuki
authors.forename: Hiroka
authors.initials: H
authors.lastname: Kondo
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology*; D016063:Blood Loss, Surgical; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009367:Neoplasm Staging; D010388:Pelvis; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects