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Study on sex differences and potential clinical value of threedimensional computerized tomography pelvimetry in rectal cancer patients

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 773-786页

作者： Xiao-Cong Zhou Fei-Yue Ke gaurav dhamija Hao Chen Qiang Wang Department of Colorectal Surgery The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Postgraduate Training Base Alliance of Wenzhou Medical University Wenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina School of International Studies Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Radiology The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina

BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various ***,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent *** To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical *** We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic *** anatomical points were carefully marked and measured using advanced 3D modeling *** analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation *** The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue *** demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal *** contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat ***,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal *** The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue *** study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical ***

关键词： Computerized tomography Rectal cancer Three-dimensional reconstruction Pelvimetry Sex differences

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Severe gastrointestinal mucositis following high dose melphalan therapy for multiple myeloma

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World Journal of Gastroenterology 2013年第5期19卷 784-785页

作者： Sanjeev Kumar Sharma Anil Handoo Dharma Choudhary gaurav dhamija Nitin Gupta Department of Hemato-oncology and Bone Marrow Transplant BLK Superspeciality HospitalNew Delhi 110005India

Mucositis is a known complication following use of chemotherapy,but fatal mucositis is unusual and management of such cases may be *** there is denudation of mucosa of gastrointestinal tract. Severe cases can develop ileus and even perforation of bowel *** report here a case of multiple myeloma who developed World Health Organization grade 4 gut mucositis following the use of high dose melphalan with the expulsion of"intestine-like"material.

关键词： Gastrointestinal mucositis Chemotherapy

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Construction of a nomogram model to predict technical difficulty in performing laparoscopic sphincter-preserving radical resection for rectal cancer

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World Journal of Gastroenterology 2024年第18期30卷 2418-2439页

作者： Xiao-Cong Zhou Shi-Wei Guan Fei-Yue Ke gaurav dhamija Qiang Wang Bang-Fei Chen Medical University(Wenzhou Central Hospital) Wenzhou 325000Zhejiang ProvinceChina Department of Hepatobiliary Surgery The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Postgraduate Training Base Alliance of Wenzhou Medical University Wenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina School of International Studies Wenzhou Medical UniversityWenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina Department of Radiology The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Department of Colorectal Surgery The Affiliated Zhejiang HospitalZhejiang University School of Medicine(Zhejiang Hospital)Hangzhou 310000Zhejiang ProvinceChina

BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic ***,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical *** To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal *** We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal ***-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)*** difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a *** Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty *** logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery.

关键词： Nomogram Rectal cancer Laparoscopic operation Sphincter-preserving surgery Technical difficulty

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