{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T15:28:06Z","timestamp":1774020486081,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T00:00:00Z","timestamp":1583452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Many studies have demonstrated predictors of the difficulty of laparoscopic anterior resection for rectal cancer. Few studies focus on the influence of pelvic dimensions on robotic\u2010assisted mesorectal excision (ME) and intersphincteric resection (ISR). This study aimed to evaluate the influences of the mesorectal fat area (MFA) and mesorectal area on the difficulty of robotic sphincter\u2010saving surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 156 patients with middle and low rectal cancer who underwent robotic sphincter\u2010saving surgery. Clinical and anatomical factors, including the pelvic dimensions, were collected. Linear regression was performed for variables associated with surgical duration. We also performed subgroup analyses for robotic\u2010assisted ME and ISR. Logistic regression was used to find variables associated with transanal dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For patients with middle or low rectal cancer, the sacral length and tumour distance from the anal verge were independently associated with surgical duration. The pT stage, sacral length and the MFA were independent predictors for the surgical duration of robotic\u2010assisted ME. By contrast, a small mesorectal area was independently related to a longer duration of robotic\u2010assisted ISR. The pelvic outlet length was independently associated with the use of transanal dissection for ISR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is suggested that a large MFA could affect the difficulty of ME in robotic\u2010assisted ME, while a small mesorectal area could increase the surgical difficulty of robotic\u2010assisted ISR for low rectal cancer. Besides, the pelvic outlet length was associated with the use of transanal dissection. Further studies are needed to validate the results and draw more scientific conclusions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15012","type":"journal-article","created":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T13:50:35Z","timestamp":1581342635000},"page":"1130-1138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Mesorectal fat area and mesorectal area affect the surgical difficulty of robotic\u2010assisted mesorectal excision and intersphincteric resection respectively in different ways"],"prefix":"10.1111","volume":"22","author":[{"given":"S.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital Fuzhou China"},{"name":"Training Center of Minimally Invasive Surgery Fujian Medical University Union Hospital Fuzhou 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