Predictive value of sacrococcygeal distance measured by CT for early postoperative complications in Lap-ISR

WANG Mei; ZOU Chengcheng; JIANG Honghong; ZHANG Jian; ZHAO Yujuan; YIN Shuhui; DING Jianhua; CAO Yu

doi:10.3969/j.issn.1009-0460.2025.09.012

Abstract：Objective To explore the correlation between preoperative CT measurement of pelvic parameters and early complications after laparoscopic intersphincter resection(Lap-ISR).Methods A total of 119 patients who underwent Lap-ISR due to ultra-low rectal cancer at the Rocket Force Characteristic Medical Center from April 2023 to June 2024 were collected,and the occurrence of complications within 30 days after the operation was recorded.Patients were grouped based on whether complications occurred.Univariate analysis was used to screen for relevant risk factors.Multivariate Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship between pelvic parameters measured by CT and early postoperative complications.The results of univariate analysis showed that The operation time was≥204 min(P=0.001),the anteroposterior diameter of the pelvic entrance was<115 mm(P=0.001),the sacrococcygeal pubic Angle was<49°(P<0.001),the sacrococcygeal distance was≥130 mm(P<0.001),and the interspinous diameter of the ischium in the middle pelvis was≥102 mm(P=0.028)was significantly associated with early postoperative complications.Multivariate Logistic regression analysis confirmed that a sacrococcygeal distance of≥130 mm was a risk factor for early postoperative complications(P=0.003,OR=0.095,95%CI:0.02-0.459).ROC curve analysis indicated that the sacrococcygeal distance had a good predictive efficacy for the occurrence of complications(AUC=0.829,95%CI:0.741-0.917,P<0.001).Conclusion The sacrococcygeal distance measured by preoperative CT is a reliable indicator for predicting early complications after Lap-ISR.Evaluating and formulating individualized surgical plans based on this before surgery is helpful to improve the safety and quality of the surgery and improve the prognosis of patients.