| Popis: |
Background:- Rectal cancer continues to be a challenging disease which most of the time needs proper staging and multimodal management to achieve the best possible cure rates. For operating surgeons, many factors may play a role in predicting the technical difficulties while conducting the operation.Objective: Objective of this study is to understand the relationship between Age, body mass index (BMI), Gender and patients anatomical factors on operating time in resection of mid-low rectal cancer.Methods: This was a prospective observational study conducted over a period of two years from Sept 2015 to Sept 2017. The study was conducted in the Department of General and Minimal Invasive Surgery, SKIMS which included 29 patients with mid-lower rectal cancer, who underwent anterior resection. Demographic data, body mass index (BMI), distance of tumor from anal verge and pelvimetry measurements were collected and analyzed with respect to operating time using co-relation coefficient analysis, principal component analysis, and linear regression.Results: The study included 20 (68.96%) females and 9 (31.03%) males.The mean operating time was 136.72±30.09. Multivariate analysis showed that parameters such as BMI (P=0.05), anatomical transverse distance (IP) (P=0.000), interischial distance (IS) (0.004), intertuberous distance (IT) (P=0.003), angle 5 (the angle of the lower border of symphysis pubis to the upper border of symphysis pubis to the sacralpromontory) (p=0.017) and distance of tumor from anal verge (Td) (p=0.001), were statistically significant. Whereas parameters such as Interacetabular distance (IA) (P=0.11) and distance from Pubis to coccyx (COSY) (P=0.674) had no statistical significance.Conclusion: Gender, BMI, angle 5, tumor distance from anal verge, transverse diameters of the pelvis except IA, and COSY played the most important role in affecting operating time. The equation can be very useful tool for pre-operative assessment. JMS 2018: 21 (2):77-83 |
