| Added by | mollevi |
|---|---|
| Group name | EquipeMY |
| Item Type | Journal Article |
| Title | MRI-based score to predict surgical difficulty in patients with rectal cancer |
| Creator | Escal et al. |
| Author | L. Escal |
| Author | S. Nougaret |
| Author | B. Guiu |
| Author | M. M. Bertrand |
| Author | H. de Forges |
| Author | R. Tetreau |
| Author | P. Rouanet |
| Abstract | BACKGROUND: Rectal cancer surgery is technically challenging and depends on many factors. This study evaluated the ability of clinical and anatomical factors to predict surgical difficulty in total mesorectal excision. METHODS: Consecutive patients who underwent total mesorectal excision for locally advanced rectal cancer in a laparoscopic, robotic or open procedure after neoadjuvant treatment, between 2005 and 2014, were included in this retrospective study. Preoperative clinical and MRI data were studied to develop a surgical difficulty grade. RESULTS: In total, 164 patients with a median age of 61 (range 26-86) years were considered to be at low risk (143, 87ˇ2 per cent) or high risk (21, 12ˇ8 per cent) of surgical difficulty. In multivariable analysis, BMI at least 30?kg/m2 (P?=?0ˇ021), coloanal anastomosis (versus colorectal) (P?=?0ˇ034), intertuberous distance less than 10ˇ1?cm (P?=?0ˇ041) and mesorectal fat area exceeding 20ˇ7?cm2 (P?=?0ˇ051) were associated with greater surgical difficulty. A four-item score (ranging from 0 to 4), with each item (BMI, type of surgery, intertuberous distance and mesorectal fat area) scored 0 (absence) or 1 (presence), is proposed. Patients can be considered at high risk of a difficult or challenging operation if they have a score of 3 or more. CONCLUSION: This simple morphometric score may assist surgical decision-making and comparative study by defining operative difficulty before surgery. |
| Publication | The British Journal of Surgery |
| Volume | 105 |
| Issue | 1 |
| Pages | 140-146 |
| Date | Jan 2018 |
| Journal Abbr | Br J Surg |
| Language | eng |
| DOI | 10.1002/bjs.10642 |
| ISSN | 1365-2168 |
| Library Catalog | PubMed |
| Extra | PMID: 29088504 |
| Tags | Adult, Aged, Aged, 80 and over, Clinical Decision-Making, Decision Support Techniques, Female, Humans, Logistic Models, Magnetic Resonance Imaging, Male, Middle Aged, Multivariate Analysis, original, Rectal Neoplasms, Rectum, Retrospective Studies |
| Date Added | 2018/11/13 - 17:35:07 |
| Date Modified | 2019/05/21 - 13:15:10 |
Institut de Recherche en Cancérologie de
