Cargando…
Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer
BACKGROUND: In some surgical disciplines, navigation-assisted surgery has become standard of care, but in rectal cancer, indications for navigation and the utility of different technologies remain undetermined. METHODS: The NAVI-LARRC prospective study (NCT 04512937; IDEAL Stage 2a) evaluated feasib...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562504/ https://www.ncbi.nlm.nih.gov/pubmed/37481493 http://dx.doi.org/10.1245/s10434-023-13964-9 |
_version_ | 1785118144567705600 |
---|---|
author | Solbakken, Arne M. Sellevold, Simen Spasojevic, Milan Julsrud, Lars Emblemsvåg, Hanne-Line Reims, Henrik M. Sørensen, Olaf Thorgersen, Ebbe B. Fauske, Lena Ågren, Joanna Sara Maria Brennhovd, Bjørn Ryder, Truls Larsen, Stein G. Flatmark, Kjersti |
author_facet | Solbakken, Arne M. Sellevold, Simen Spasojevic, Milan Julsrud, Lars Emblemsvåg, Hanne-Line Reims, Henrik M. Sørensen, Olaf Thorgersen, Ebbe B. Fauske, Lena Ågren, Joanna Sara Maria Brennhovd, Bjørn Ryder, Truls Larsen, Stein G. Flatmark, Kjersti |
author_sort | Solbakken, Arne M. |
collection | PubMed |
description | BACKGROUND: In some surgical disciplines, navigation-assisted surgery has become standard of care, but in rectal cancer, indications for navigation and the utility of different technologies remain undetermined. METHODS: The NAVI-LARRC prospective study (NCT 04512937; IDEAL Stage 2a) evaluated feasibility of navigation in patients with locally advanced primary (LARC) and recurrent rectal cancer (LRRC). Included patients had advanced tumours with high risk of incomplete (R1/R2) resection, and navigation was considered likely to improve the probability of complete resection (R0). Tumours were classified according to pelvic compartmental involvement, as suggested by the Royal Marsden group. The Brainlab(TM) navigation platform was used for preoperative segmentation of tumour and pelvic anatomy, and for intraoperative navigation with optical tracking. R0 resection rates, surgeons’ experiences, and adherence to the preoperative resection plan were assessed. RESULTS: Seventeen patients with tumours involving the posterior/lateral compartments underwent navigation-assisted procedures. Fifteen patients required abdominosacral resection, and 3 had resection of the sciatic nerve. R0 resection was obtained in 6/8 (75%) LARC and 6/9 (69%) LRRC cases. Preoperative segmentation was time-consuming (median 3.5 h), but intraoperative navigation was accurate. Surgeons reported navigation to be feasible, and adherence to the resection plan was satisfactory. CONCLUSIONS: Navigation-assisted surgery using optical tracking was feasible. The preoperative planning was time-consuming, but intraoperative navigation was accurate and resulted in acceptable R0 resection rates. Selected patients are likely to benefit from navigation-assisted surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-023-13964-9. |
format | Online Article Text |
id | pubmed-10562504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-105625042023-10-11 Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer Solbakken, Arne M. Sellevold, Simen Spasojevic, Milan Julsrud, Lars Emblemsvåg, Hanne-Line Reims, Henrik M. Sørensen, Olaf Thorgersen, Ebbe B. Fauske, Lena Ågren, Joanna Sara Maria Brennhovd, Bjørn Ryder, Truls Larsen, Stein G. Flatmark, Kjersti Ann Surg Oncol Colorectal Cancer BACKGROUND: In some surgical disciplines, navigation-assisted surgery has become standard of care, but in rectal cancer, indications for navigation and the utility of different technologies remain undetermined. METHODS: The NAVI-LARRC prospective study (NCT 04512937; IDEAL Stage 2a) evaluated feasibility of navigation in patients with locally advanced primary (LARC) and recurrent rectal cancer (LRRC). Included patients had advanced tumours with high risk of incomplete (R1/R2) resection, and navigation was considered likely to improve the probability of complete resection (R0). Tumours were classified according to pelvic compartmental involvement, as suggested by the Royal Marsden group. The Brainlab(TM) navigation platform was used for preoperative segmentation of tumour and pelvic anatomy, and for intraoperative navigation with optical tracking. R0 resection rates, surgeons’ experiences, and adherence to the preoperative resection plan were assessed. RESULTS: Seventeen patients with tumours involving the posterior/lateral compartments underwent navigation-assisted procedures. Fifteen patients required abdominosacral resection, and 3 had resection of the sciatic nerve. R0 resection was obtained in 6/8 (75%) LARC and 6/9 (69%) LRRC cases. Preoperative segmentation was time-consuming (median 3.5 h), but intraoperative navigation was accurate. Surgeons reported navigation to be feasible, and adherence to the resection plan was satisfactory. CONCLUSIONS: Navigation-assisted surgery using optical tracking was feasible. The preoperative planning was time-consuming, but intraoperative navigation was accurate and resulted in acceptable R0 resection rates. Selected patients are likely to benefit from navigation-assisted surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-023-13964-9. Springer International Publishing 2023-07-23 2023 /pmc/articles/PMC10562504/ /pubmed/37481493 http://dx.doi.org/10.1245/s10434-023-13964-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Colorectal Cancer Solbakken, Arne M. Sellevold, Simen Spasojevic, Milan Julsrud, Lars Emblemsvåg, Hanne-Line Reims, Henrik M. Sørensen, Olaf Thorgersen, Ebbe B. Fauske, Lena Ågren, Joanna Sara Maria Brennhovd, Bjørn Ryder, Truls Larsen, Stein G. Flatmark, Kjersti Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title | Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title_full | Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title_fullStr | Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title_full_unstemmed | Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title_short | Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer |
title_sort | navigation-assisted surgery for locally advanced primary and recurrent rectal cancer |
topic | Colorectal Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562504/ https://www.ncbi.nlm.nih.gov/pubmed/37481493 http://dx.doi.org/10.1245/s10434-023-13964-9 |
work_keys_str_mv | AT solbakkenarnem navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT sellevoldsimen navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT spasojevicmilan navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT julsrudlars navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT emblemsvaghanneline navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT reimshenrikm navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT sørensenolaf navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT thorgersenebbeb navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT fauskelena navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT agrenjoannasaramaria navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT brennhovdbjørn navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT rydertruls navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT larsensteing navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer AT flatmarkkjersti navigationassistedsurgeryforlocallyadvancedprimaryandrecurrentrectalcancer |