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- Publisher Website: 10.1007/s00464-019-07112-2
- Scopus: eid_2-s2.0-85072034557
- PMID: 31506793
- WOS: WOS:000544420600013
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Article: Predicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision
Title | Predicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision |
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Authors | |
Keywords | Total mesorectal excision Double-stapling technique MRI pelvimetry |
Issue Date | 2020 |
Publisher | Springer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/ |
Citation | Surgical Endoscopy, 2020, v. 34, p. 3382-3387 How to Cite? |
Abstract | Background:
The transection of rectum and fashioning of anastomosis is a crucial step in laparoscopic total mesorectal excision (TME) and the double-stapling technique (DST) is often employed. This study aimed to evaluate the factors that were associated with difficult DST.
Method:
Cases of laparoscopic TME were retrospectively reviewed. The clinico-anatomical parameters were retrieved from a prospectively maintained database. In addition, pelvic dimensions were taken by reviewing the magnetic resonance imaging scan. The number of stapler cartridges used for intracorporeal transection of rectum was used as a surrogate for the level of difficulty of DST and its relationship with various parameters were evaluated.
Results:
There were a total of 121 consecutive cases analyzed. The mean number of stapler cartridges used was 2.1 ± 0.7. Pelvic inlet (p = 0.002) and tumor height (p = 0.015) were predictors of the number of cartridges used, R2 = 0.366. A model was developed to predict the likelihood of transecting the rectum with two or less stapler cartridges, which included the following parameters: gender, pelvic inlet, interspinous distance, intertuberous distance, and tumor height. The predicted probability also correlated with overall operation time (p = 0.009) and anastomotic leakage (p = 0.023).
Conclusion:
The difficulty of DST was associated with patient’s clinico-anatomical factors. Surgeons can consider other feasible alternatives, like transanal anastomosis, when a technically challenging DST is anticipated. |
Persistent Identifier | http://hdl.handle.net/10722/279140 |
ISSN | 2023 Impact Factor: 2.4 2023 SCImago Journal Rankings: 1.120 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Foo, CC | - |
dc.contributor.author | Hung, HT | - |
dc.contributor.author | Ho, YC | - |
dc.contributor.author | Lam, WWM | - |
dc.contributor.author | Law, WL | - |
dc.date.accessioned | 2019-10-21T02:20:18Z | - |
dc.date.available | 2019-10-21T02:20:18Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Surgical Endoscopy, 2020, v. 34, p. 3382-3387 | - |
dc.identifier.issn | 0930-2794 | - |
dc.identifier.uri | http://hdl.handle.net/10722/279140 | - |
dc.description.abstract | Background: The transection of rectum and fashioning of anastomosis is a crucial step in laparoscopic total mesorectal excision (TME) and the double-stapling technique (DST) is often employed. This study aimed to evaluate the factors that were associated with difficult DST. Method: Cases of laparoscopic TME were retrospectively reviewed. The clinico-anatomical parameters were retrieved from a prospectively maintained database. In addition, pelvic dimensions were taken by reviewing the magnetic resonance imaging scan. The number of stapler cartridges used for intracorporeal transection of rectum was used as a surrogate for the level of difficulty of DST and its relationship with various parameters were evaluated. Results: There were a total of 121 consecutive cases analyzed. The mean number of stapler cartridges used was 2.1 ± 0.7. Pelvic inlet (p = 0.002) and tumor height (p = 0.015) were predictors of the number of cartridges used, R2 = 0.366. A model was developed to predict the likelihood of transecting the rectum with two or less stapler cartridges, which included the following parameters: gender, pelvic inlet, interspinous distance, intertuberous distance, and tumor height. The predicted probability also correlated with overall operation time (p = 0.009) and anastomotic leakage (p = 0.023). Conclusion: The difficulty of DST was associated with patient’s clinico-anatomical factors. Surgeons can consider other feasible alternatives, like transanal anastomosis, when a technically challenging DST is anticipated. | - |
dc.language | eng | - |
dc.publisher | Springer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/ | - |
dc.relation.ispartof | Surgical Endoscopy | - |
dc.rights | This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI] | - |
dc.subject | Total mesorectal excision | - |
dc.subject | Double-stapling technique | - |
dc.subject | MRI pelvimetry | - |
dc.title | Predicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision | - |
dc.type | Article | - |
dc.identifier.email | Foo, CC: ccfoo@hku.hk | - |
dc.identifier.email | Law, WL: lawwl@hkucc.hku.hk | - |
dc.identifier.authority | Foo, CC=rp01899 | - |
dc.identifier.authority | Law, WL=rp00436 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00464-019-07112-2 | - |
dc.identifier.pmid | 31506793 | - |
dc.identifier.scopus | eid_2-s2.0-85072034557 | - |
dc.identifier.hkuros | 308168 | - |
dc.identifier.volume | 34 | - |
dc.identifier.spage | 3382 | - |
dc.identifier.epage | 3387 | - |
dc.identifier.isi | WOS:000544420600013 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0930-2794 | - |