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Discrepancy between surgeon and radiological assessment of ligation level of the inferior mesenteric artery in patients operated for rectal cancer-impacting registry-based research and surgical practice
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
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2021 (Engelska)Ingår i: World Journal of Surgical Oncology, E-ISSN 1477-7819, Vol. 19, nr 1, artikel-id 115Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: The reliability of the registered ligation level of the inferior mesenteric artery (IMA) in the Swedish Colorectal Cancer Registry has been questioned. The primary aim of this study was to evaluate this parameter in the registry by comparing the registered ligation levels with a postoperative computed tomography angiography (CT-angiography) in patients operated for rectal cancer.

METHODS: Patients operated for rectal cancer at two Swedish university hospitals were prospectively included between December 2016 and December 2019. At the 1-year postoperative follow-up, an additional CT-angiography was performed and independently examined by two radiologists. The radiological assessment of the ligation level was compared to registry data, using different measures of agreement.

RESULTS: A total of 94 patients were included, 55 (59%) were men and 39 (41%) women. All patients underwent abdominal resection: conventional or robot-assisted laparoscopic surgery, n=56 (60%), or open resection, n=38 (40%). The ligation level as assessed on CT-angiography was high in 29 (31%) patients and low in 65 (69%). The registered level of ligation of the IMA and the radiological assessment of the CT-angiographies were consistent in 77/94 cases, demonstrating an 82% agreement and a sensitivity and specificity of 86% and 72%, respectively. The estimated Kappa value was 0.58, reaching 0.64 after prevalence bias adjustment.

CONCLUSION: This study showed that CT-angiography can be used to evaluate the reliability of the registered ligation level in the Swedish Colorectal Cancer Registry. The demonstrated agreement between the registry and postoperative CT-angiography was moderate to good. This discrepancy impacts registry-based research using IMA ligation data and may ultimately influence surgical practice.

TRIAL REGISTRATION: Clinical Trials identifier NCT03875612.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2021. Vol. 19, nr 1, artikel-id 115
Nyckelord [en]
Anatomy, CT, Computed tomography angiography, High tie, Ligation level, Low tie, Validation
Nationell ämneskategori
Kirurgi
Identifikatorer
URN: urn:nbn:se:umu:diva-183307DOI: 10.1186/s12957-021-02222-5ISI: 000640239500003PubMedID: 33849560Scopus ID: 2-s2.0-85104252251OAI: oai:DiVA.org:umu-183307DiVA, id: diva2:1556392
Forskningsfinansiär
Knut och Alice Wallenbergs StiftelseCancerforskningsfonden i NorrlandTillgänglig från: 2021-05-21 Skapad: 2021-05-21 Senast uppdaterad: 2024-01-16Bibliografiskt granskad

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Wikner, FranciskaLegrell, PetterRutegård, Martin

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Wikner, FranciskaLegrell, PetterRutegård, Martin
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Diagnostisk radiologiKirurgiWallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)
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World Journal of Surgical Oncology
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