Postoperative MRI Findings Following Conventional and Extralevator Abdominoperineal Excision in Low Rectal Cancer
Autor: | P. Bondeven, Bodil Ginnerup Pedersen, Henrik Christensen, Rikke Hagemann-Madsen, Søren Laurberg, Kim Morgenstjerne Oerskov, Henrik Hein Lauridsen |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Pelvic MRI medicine.diagnostic_test RD1-811 business.industry Colorectal cancer Magnetic resonance imaging Postoperative mri APE medicine.disease Diaphragm (structural system) Low rectal cancer extralevator abdominoperineal excision Cohort medicine ELAPE magnetic resonance imaging Surgery Radiology Risk factor business rectal cancer Original Research |
Zdroj: | Oerskov, K M, Bondeven, P, Laurberg, S, Hagemann-Madsen, R H, Christensen, H K, Lauridsen, H & Pedersen, B G 2021, ' Postoperative MRI Findings Following Conventional and Extralevator Abdominoperineal Excision in Low Rectal Cancer ', Frontiers in Surgery, vol. 8, 771107 . https://doi.org/10.3389/fsurg.2021.771107 Frontiers in Surgery Oerskov, K M, Bondeven, P, Laurberg, S, Hagemann-Madsen, R H, Christensen, H K, Lauridsen, H & Pedersen, B G 2021, ' Postoperative MRI findings following conventional and extralevator abdominoperineal excision in low rectal cancer ', Frontiers in Surgery, vol. 8, 771107 . https://doi.org/10.3389/fsurg.2021.771107 Frontiers in Surgery, Vol 8 (2021) |
Popis: | Aim: The disparity in outcomes for low rectal cancer may reflect differences in operative approach and quality. The extralevator abdominoperineal excision (ELAPE) was developed to reduce margin involvement in low rectal cancers by widening the excision of the conventional abdominoperineal excision (c-APE) to include the posterior pelvic diaphragm. This study aimed to determine the prevalence and localization of inadvertent residual pelvic diaphragm on postoperative MRI after intended ELAPE and c-APE.Methods: A total of 147 patients treated with c-APE or ELAPE for rectal cancer were included. Postoperative MRI was performed on 51% of the cohort (n = 75) and evaluated with regard to the residual pelvic diaphragm by a radiologist trained in pelvic MRI. Patient records, histopathological reports, and standardized photographs were assessed. Pathology and MRI findings were evaluated independently in a blinded fashion. Additionally, preoperative MRIs were evaluated for possible risk factors for margin involvement.Results: Magnetic resonance imaging-detected residual pelvic diaphragm was identified in 45 (75.4%) of 61 patients who underwent ELAPE and in 14 (100%) of 14 patients who underwent c-APE. An increased risk of margin involvement was observed in anteriorly oriented tumors with 16 (22%) of 73 anteriorly oriented tumors presenting with margin involvement vs. 7 (9%) of 74 non-anteriorly oriented tumors (p = 0.038).Conclusion: Residual pelvic diaphragm following abdominoperineal excision can be depicted by postoperative MRI. Inadvertent residual pelvic diaphragm (RPD) was commonly found in the series of patients treated with the ELAPE technique. Anterior tumor orientation was a risk factor for circumferential resection margin (CRM) involvement regardless of surgical approach. |
Databáze: | OpenAIRE |
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