Pelvimetric and Nutritional Factors Predicting Surgical Difficulty in Laparoscopic Resection for Rectal Cancer Following Preoperative Chemoradiotherapy

Laparoscopic total mesorectal excision (LaTME) following preoperative chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC) is technically demanding. The present study intended to evaluate predictive factors of surgical difficulty LaTME PCRT by using pelvimetric and nutritional factors. Consecutive LARC patients receiving after were included. Surgical was classified based upon intraoperative (operation time, blood loss, conversion) postoperative outcomes (postoperative hospital stay morbidities). Pelvimetry performed T2-weighted MRI. Nutritional such as albumin-to-globulin ratio (AGR) prognostic index (PNI) calculated. Multivariable logistic analysis used identify predictors high difficulty. A nomogram developed validated internally. Among 294 included, 36 (12.4%) graded Logistic regression demonstrated that previous abdominal surgery (OR = 6.080, P 0.001), tumor diameter 1.732, 0.003), intersphincteric resection (vs. low anterior resection, OR 13.241, < interspinous distance 0.505, 0.009), AGR 0.041, 0.024) independently PCRT. Then, a built (C-index 0.867). Besides surgery, type (intersphincteric resection), diameter, distance, we found could be useful for the prediction may aid planning an appropriate approach