Abstract
Laparoscopic low anterior resection (LLAR) for rectal cancer is regarded as a very difficult surgical procedure. A narrow pelvis is a reported to be a factor of postoperative complications. The aim of the present study was to analyze the clinical and anatomical factors in the treatment of rectal cancer by means of LLAR. Pelvimetry data [pelvic volume (PV), rectal volume (RV), pelvic inlet, pelvic outlet, abdominal wall (AW), subcutaneous fat (SF), and muscle layer(ML)] were included in anatomical factors. Gender, intraoperative blood loss, body weight, body height, body mass index (BMI), and tumor location were included in clinical factors. Pelvic operative time (POT) was used as an indicator of the difficulty of performing LLAR to treat rectal cancer. A database of patients treated within a single institution was studied retrospectively. Between April 2013 and March 2015, 50 consecutive patients underwent LLAR for rectal cancer at Iwate Medical University Hospital. Body weight (r=0.417) was related to POT. BMI (r = 0.332), intraoperative blood loss (r=0.263), PV (r=-0.293), RV (r=0.230), and ML (r=-0.290) were weakly related to POT. Univariate analysis revealed that BMI (p=0.007), body weight (p=0.005), and PV (p=0.028) were independently corelated with POT. Multivariate analysis showed that PV (p=0.047) was significantly corelated with POT. Therefore, we suggested that PV is a useful and independent predictor of difficulty in performing LLAR for rectal cancer.
