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Article: Predicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision

TitlePredicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision
Authors
KeywordsTotal mesorectal excision
Double-stapling technique
MRI pelvimetry
Issue Date2020
PublisherSpringer 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?
AbstractBackground: 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 Identifierhttp://hdl.handle.net/10722/279140
ISSN
2019 Impact Factor: 3.149
2015 SCImago Journal Rankings: 1.695

 

DC FieldValueLanguage
dc.contributor.authorFoo, CC-
dc.contributor.authorHung, HT-
dc.contributor.authorHo, YC-
dc.contributor.authorLam, WWM-
dc.contributor.authorLaw, WL-
dc.date.accessioned2019-10-21T02:20:18Z-
dc.date.available2019-10-21T02:20:18Z-
dc.date.issued2020-
dc.identifier.citationSurgical Endoscopy, 2020, v. 34, p. 3382-3387-
dc.identifier.issn0930-2794-
dc.identifier.urihttp://hdl.handle.net/10722/279140-
dc.description.abstractBackground: 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.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/-
dc.relation.ispartofSurgical Endoscopy-
dc.rightsThis 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.subjectTotal mesorectal excision-
dc.subjectDouble-stapling technique-
dc.subjectMRI pelvimetry-
dc.titlePredicting the level of difficulty of the double-stapling technique in laparoscopic total mesorectal excision-
dc.typeArticle-
dc.identifier.emailFoo, CC: ccfoo@hku.hk-
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hk-
dc.identifier.authorityFoo, CC=rp01899-
dc.identifier.authorityLaw, WL=rp00436-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-019-07112-2-
dc.identifier.pmid31506793-
dc.identifier.scopuseid_2-s2.0-85072034557-
dc.identifier.hkuros308168-
dc.identifier.volume34-
dc.identifier.spage3382-
dc.identifier.epage3387-
dc.publisher.placeUnited States-

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