Evidence map›Paper›PMID 40220058›Full record

ArticleTechniques in coloproctology2025

Is computed tomography assessment of residual arterial pedicle length following colorectal cancer surgery a useful marker of surgical quality?

K Naidu, P Chapuis, J Yang, S Koneru, C Chan, M Rickard, K-S Ng

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Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

K NaiduColorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia.
P ChapuisColorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia.
J YangConcord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Concord, NSW, 2139, Australia.
S KoneruColorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia.
C ChanConcord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Concord, NSW, 2139, Australia.
M RickardColorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia.
K-S NgColorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia. k.s.ng@sydney.edu.au.

Funding

Colorectal Surgical Society of Australia and New Zealand CSSANZ Foundation Education GrantColorectal Surgical Society of Australia and New Zealand Medtronic Colorectal Research FellowshipFaculty of Medicine and Health, University of Sydney Senior Lecturer FellowshipRoyal Australasian College of Surgeons Eric Bishop Research Scholarship
6 · The paper itself

Abstract

backgroundIn vivo residual arterial pedicle length (RAPL) has been proposed as a quality indicator for central vascular ligation (CVL [i.e., RAPL ≤ 10 mm]) in colorectal cancer (CRC) surgery. However, its survival association in non-routine CVL practice requires clarification. This study aimed to assess the feasibility and reproducibility of measuring RAPL alongside its oncological associations in non-routine CVL surgery.

methodsA prospective cohort study at Concord Hospital was conducted on anterior resection (AR) or right hemicolectomy (RH) patients with stage I to III CRC (1995-2019). Using surveillance computed tomography (CT), RAPL of the inferior mesenteric artery (IMA) or ileo-colic artery (ICA) pedicle was measured independently by two observers. The intra-class correlation coefficient assessed the reproducibility of the measurements. Kaplan-Meier and univariate Cox regression analyses estimated overall survival (OS) and disease-free survival (DFS), while univariate and multivariate linear regression models tested correlations between RAPL and clinicopathological features.

resultsA total of 1425 patients underwent a CRC operation. Post-operative CTs were reviewed in 424 patients, with 422 (mean age 69.0 years [SD 12.3]; 54.0% males) RAPLs measured. The majority studied underwent an AR (59.2%). Excellent inter-rater reliability was noted in AR (ICC = 0.97; P < 0.001) and RH (ICC = 0.89; P < 0.001) patients. No association was observed between RAPL and OS or DFS in either group. Also, RAPL lacked association with nodal harvest in either AR (P = 0.54) or RH (P = 0.16) patients.

conclusionThe value of RAPL as a quality marker of CRC surgery in non-routine CVL practice has not been confirmed. Furthermore, its lack of association with nodal harvest emphasizes the importance and the need for comprehensive pathology examination of the specimen following resection of CRC.

Indexed as

ColectomyColorectal NeoplasmsMesenteric Artery, InferiorTomography, X-Ray ComputedAgedAged, 80 and overDisease-Free SurvivalFeasibility StudiesFemaleHumansLigationMaleMiddle AgedProspective StudiesReproducibility of ResultsCMECVLResidual arterial pedicle lengthTissue morphometry

Identifiers

PMID40220058
PMCPMC11993473

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