| Objective: To evaluate the predictive value of pelvic anatomical parameters measured by preoperative CT and pathological parameters for the difficulties when performing laparoscopic rectal surgery for mid?low rectal cancer and establish a scoring system for predicting.Method: Univariable analysis of anatomical parameters by preoperative CT and pathological parameters in 80 patients laparoscopic rectal surgery for mid?low rectal cancer in our department between October 2014 and February 2018.Multiple logistic regression was performed to identify risk factors that were subsequently scored.A scoring system was then established.ROC curve was used to evaluate the value of this scoring system.Result: : A total of 80 patients were included in the study,40 in the easy group and 40 in the difficult group.Univariate analysis of tumor location,height of the pubic symphysis,interspinous diameter,the ratio of anteroposterior diameter of the mid?pelvis to interspinous diameter,the ratio of height of the pubic symphysis to anteroposterior diameter of the mid?pelvis,the ratio of height of the pubic symphysis to interspinous diameter and the ratio of the sacral distance to interspinous diameter were statistically significant.Bringing the above variables into multivariate analysis showed that tumor location,the ratio of height of the pubic symphysis to anteroposterior diameter of the mid?pelvis,the ratio of height of the pubic symphysis to interspinous diameter might be an influencing factor for the difficulty of the operation.The AUC of the ROC curve was 0.744(SE=0.056,P=0.000,95% CI=0.635~0.853),and the cutoff value was 1.65,which had certain accuracy.The higher the score,the greater the difficulty of surgery.Conclusion: Lower tumor location,deeper and narrower pelvis caused an increase in the difficulty of surgery.The establishment of the scoring system is helpful for the preoperative screening cases to choose the best Surgical method. |
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