Produção Nacional
Revisado por pares
Definition of the Rectum
2019; Lippincott Williams & Wilkins; Volume: 270; Issue: 6 Linguagem: Inglês
10.1097/sla.0000000000003251
ISSN1528-1140
AutoresNigel D’Souza, Michael P.M. de Neree tot Babberich, André D’Hoore, Emmanuel Tiret, Evaghelos Xynos, Geerard L. Beets, Irıs D. Nagtegaal, Lennart Blomqvist, Torbjörn Holm, Bengt Glimelius, Antonio M. Lacy, Andrés Cervantes, Rob Glynne‐Jones, Nicholas P. West, Rodrigo Oliva Perez, Claudio Almeida Quadros, Kil Yeon Lee, T E Madiba, Steven D. Wexner, Julio García‐Aguilar, Dushyant V. Sahani, Brendan Moran, Paris Tekkis, H.J.T. Rutten, Pieter J. Tanis, Theo Wiggers, Gina Brown,
Tópico(s)Radiomics and Machine Learning in Medical Imaging
ResumoThe wide global variation in the definition of the rectum has led to significant inconsistencies in trial recruitment, clinical management, and outcomes. Surgical technique and use of preoperative treatment for a cancer of the rectum and sigmoid colon are radically different and dependent on the local definitions employed by the clinical team. A consensus definition of the rectum is needed to standardise treatment.The consensus was conducted using the Delphi technique with multidisciplinary colorectal experts from October, 2017 to April, 2018.Eleven different definitions for the rectum were used by participants in the consensus. Magnetic resonance imaging (MRI) was the most frequent modality used to define the rectum (67%), and the preferred modality for 72% of participants. The most agreed consensus landmark (56%) was "the sigmoid take-off," an anatomic, image-based definition of the junction of the mesorectum and mesocolon. In the second round, 81% of participants agreed that the sigmoid take-off as seen on computed tomography or MRI achieved consensus, and that it could be implemented in their institution. Also, 87% were satisfied with the sigmoid take-off as the consensus landmark.An international consensus definition for the rectum is the point of the sigmoid take-off as visualized on imaging. The sigmoid take-off can be identified as the mesocolon elongates as the ventral and horizontal course of the sigmoid on axial and sagittal views respectively on cross-sectional imaging. Routine application of this landmark during multidisciplinary team discussion for all patients will enable greater consistency in tumour localisation.
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