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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorJULIAO, Guilherme Pagin Sao-
dc.contributor.authorORTEGA, Cinthia D.-
dc.contributor.authorVAILATI, Bruna Borba-
dc.contributor.authorCOUTINHO, Francisco A. B.-
dc.contributor.authorROSSI, Gustavo-
dc.contributor.authorHABR-GAMA, Angelita-
dc.contributor.authorFERNANDEZ, Laura Melina-
dc.contributor.authorARAUJO, Sergio Eduardo Alonso-
dc.contributor.authorBROWN, Gina-
dc.contributor.authorPEREZ, Rodrigo Oliva-
dc.identifier.citationWORLD JOURNAL OF SURGERY, v.42, n.11, p.3765-3770, 2018-
dc.description.abstractObjective To estimate the improvement in surgical exposure by removal of the coccyx, during abdomino-perineal resection (APR), in rectal cancer patients. Methods Retrospective study of 29 consecutive patients with rectal cancer was carried out. Using MR T2 sagittal series, the solid angle was estimated using the angle determined by the anterior resection margin and the tip of coccyx (no coccyx resection) or the tip of last sacral vertebra (coccyx resection). The solid angle provides an estimate of the tridimensional surface area provided by an original angle resulting in the best estimate of the surgeon's view/exposure to the critical dissecting point of choice (anterior rectal wall). The difference (""Gain"") in surgical field exposure by removal of the coccyx was compared by the solid angle variation between the two estimates (with and without the coccyx). Results Routine removal of the coccyx determines an average 42% (95% CI 27-57%) gain in surgical field exposure area facing the anterior rectal wall at the level of the prostate/vagina by the surgeon. Fifteen (51%) patients had >= 30% (median) estimated gain in surgical field exposure by coccygectomy. There was no association between BMI, age or gender and estimated gain in surgical field exposure area. Conclusions Routine removal of the coccyx during APR may result in an average increase in 42% in surgical field exposure during APR's perineal dissection. Precise estimation of surgical field exposure gain by removal of the coccyx may be predicted by MR sagittal series for each individual patient.-
dc.relation.ispartofWorld Journal of Surgery-
dc.subject.otherlow rectal-cancer-
dc.subject.otherextralevator abdominoperineal excision-
dc.subject.otheranterior resection-
dc.titleThe Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance-
dc.rights.holderCopyright SPRINGER-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Guilherme Pagin Sao:Angelita & Joaquim Gama Inst, Rua Manoel da Nobrega 1564, BR-04001005 Sao Paulo, SP, Brazil-, Bruna Borba:Angelita & Joaquim Gama Inst, Rua Manoel da Nobrega 1564, BR-04001005 Sao Paulo, SP, Brazil-, Gustavo:Hosp Italiano Buenos Aires, Colorectal Surg Div, 4190 Peron St,1199ABB, Buenos Aires, DF, Argentina-, Laura Melina:Angelita & Joaquim Gama Inst, Rua Manoel da Nobrega 1564, BR-04001005 Sao Paulo, SP, Brazil-, Gina:Royal Marsden NHS Fdn Trust, Dept Radiol, Downs Rd, Sutton SM2 5PT, Surrey, England-
hcfmusp.publisher.cityNEW YORK-
hcfmusp.relation.referenceBosch SL, 2012, CURR COLORECT CANC R, V8, P90, DOI 10.1007/s11888-012-0124-7-
hcfmusp.relation.referenceBrown G, 2005, BRIT J RADIOL, V78, P245, DOI 10.1259/bjr/33540239-
hcfmusp.relation.referencede Campos-Lobato LF, 2011, DIS COLON RECTUM, V54, P939, DOI 10.1097/DCR.0b013e318221eb64-
hcfmusp.relation.referenceHabr-Gama A, 2017, WORLD J SURG, V41, P2160, DOI 10.1007/s00268-017-3963-1-
hcfmusp.relation.referenceHan JG, 2014, DIS COLON RECTUM, V57, P1333, DOI 10.1097/DCR.0000000000000235-
hcfmusp.relation.referenceHow P, 2011, SURG ONCOL, V20, pE149, DOI 10.1016/j.suronc.2011.05.001-
hcfmusp.relation.referenceNagtegaal ID, 2005, J CLIN ONCOL, V23, P9257, DOI 10.1200/JCO.2005.02.9231-
hcfmusp.relation.referenceNAITO M, 1957, J PHYS SOC JPN, V12, P1122, DOI 10.1143/JPSJ.12.1122-
hcfmusp.relation.referencePrytz M, 2016, ANN SURG, V263, P516, DOI 10.1097/SLA.0000000000001237-
hcfmusp.relation.referenceSao Juliao GP, 2017, COLORECTAL DIS, V19, pO196, DOI [10.1111/codi.13691, DOI 10.1111/CODI.13691]-
hcfmusp.relation.referenceShihab OC, 2012, COLORECTAL DIS, V14, pE655, DOI 10.1111/j.1463-1318.2012.03181.x-
hcfmusp.relation.referenceShihab OC, 2011, DIS COLON RECTUM, V54, P1260, DOI 10.1097/DCR.0b013e31822abd78-
hcfmusp.relation.referenceShihab OC, 2010, DIS COLON RECTUM, V53, P53, DOI 10.1007/DCR.0b013e3181c70465-
hcfmusp.relation.referenceTaylor FGM, 2011, ANN SURG, V253, P711, DOI 10.1097/SLA.0b013e31820b8d52-
hcfmusp.relation.referenceWang YL, 2015, CHINESE MED J-PEKING, V128, P1340, DOI 10.4103/0366-6999.156779-
hcfmusp.relation.referenceWest NP, 2010, BRIT J SURG, V97, P588, DOI 10.1002/bjs.6916-
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Artigos e Materiais de Revistas Científicas - FM/MGT
Departamento de Gastroenterologia - FM/MGT

Artigos e Materiais de Revistas Científicas - FM/MPT
Departamento de Patologia - FM/MPT

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/01
LIM/01 - Laboratório de Informática Médica

Artigos e Materiais de Revistas Científicas - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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