Dataset Information

Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.

ABSTRACT:

Introduction

Splenic flexure mobilization (SFM) may be indicated during anterior resection to provide a tension-free anastomosis. However, to date, no score allows identifying patients who may benefit from SFM.

Methods

Patients who underwent robotic anterior resection for rectal cancer were identified from a prospective register. Demographic and cancer-related variables were extracted, and predictors of SFM were identified using regression models. Thereafter, 20 patients with SFM and 20 patients without SFM were randomly selected and their pre-operative CTscan were reviewed. The radiological index was defined as 1/(sigmoid length/pelvis depth). The optimal cut-off value for predicting SFM was identified using ROC curve analysis.

Results

Five hundred and twenty-four patients were included. SFM was performed in 121 patients (27.8%) and increased operative time by 21.8 min (95% CI: 11.3 to 32.4, p < 0.001). The incidence of postoperative complications did not differ between patient with or without SFM. Realization of an anastomosis was the main predictor for SFM (OR: 42.4, 95% CI: 5.8 to 308.5, p < 0.001). In patients with colorectal anastomosis, both sigmoid length (15 ± 5.1 cm versus 24.2 ± 80.9 cm, p < 0.001) and radiological index (1 ± 0.3 versus 0.6 ± 0.2, p < 0.001) differed between patients who had SFM and patients who did not. ROC curve analysis of the radiological index indicated an optimal cut-off value of 0.8 (sensitivity: 75%, specificity: 90%).

Conclusion

SFM was performed in 27.8% of patients who underwent robotic anterior resection, and increased operative time by 21.8 min. For optimal surgical planning, patients requiring SFM can be identified based on pre-operative CT using the index 1/(sigmoid length/pelvis depth) with a cut-off value set at 0.8.

SUBMITTER: Meyer J

PROVIDER: S-EPMC10322756 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.

Meyer Jeremy J van der Schelling George G Wijsman Jan J Ris Frédéric F Crolla Rogier R

Surgical endoscopy 20230403 7

<h4>Introduction</h4>Splenic flexure mobilization (SFM) may be indicated during anterior resection to provide a tension-free anastomosis. However, to date, no score allows identifying patients who may benefit from SFM.<h4>Methods</h4>Patients who underwent robotic anterior resection for rectal cancer were identified from a prospective register. Demographic and cancer-related variables were extracted, and predictors of SFM were identified using regression models. Thereafter, 20 patients with SFM ...[more]

PMID: 37010604

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Dataset Information

Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.

Introduction

Methods

Results

Conclusion

Publications

Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis.

Similar Datasets

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