Pelvimetry of Males from the Western Cape with Rectal Cancer: Anatomical and Clinical Implication
| dc.contributor.advisor | Baatjes, Karin J. | en_ZA |
| dc.contributor.advisor | Forgan, T. R. | en_ZA |
| dc.contributor.advisor | Alblas, Amanda | en_ZA |
| dc.contributor.author | Lathe, Stephanie | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Biomedical Sciences: Anatomy and Histology. | en_ZA |
| dc.date.accessioned | 2020-11-19T09:30:59Z | |
| dc.date.accessioned | 2021-01-31T19:40:46Z | |
| dc.date.available | 2020-11-19T09:30:59Z | |
| dc.date.available | 2021-01-31T19:40:46Z | |
| dc.date.issued | 2020-12 | |
| dc.description | Thesis (MSc)--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | ENGLISH ABSTRACT: Colorectal cancer represents an increasing healthcare burden that affects South African males more commonly than females. Surgical intervention, and specifically total mesorectal excision (TME), remains a key modality in the management of rectal cancer. This procedure occurs in the spatially restricted pelvic canal. Observations of increased difficulty during TME on South African males at the Tygerberg Academic Hospital (TH) led to the impression that they display an especially narrow pelvis. Multiple evolutionary factors, such as childbirth, thermoregulation, and bipedal locomotion, have moulded the size of the modern human pelvis, with males naturally displayinga narrower pelvis than female. Climate is geographically structured and is believed to play a pivotal role in pelvic dimensions. Population groups from lower latitudes tend to exhibit a narroweranddeeperpelves compared to those from higher latitudes.The primary aim of the study was to measure the dimensions of the bony pelvis in males from the Western Cape who have undergone potentially curative colorectal cancer surgery at TH, and to compare these results with other ecogeographical regions. Secondarily, it aimed to determine if an association exists between pelvic dimensions and morbidity documented in rectal cancers patients who have undergone a TME at TH.Pelvic size was investigated by conducting nineteen pelvimetric measurements on 3D bony pelvic reconstructions of male patients (n=158) using computed tomography data. Thereafter measurements were compared with other ecogeographical regions to investigate our relative pelvic size and relationships between latitude and pelvic dimensions using forest plots. Lastly, aone-way ANOVA with a post hoc Bonferroni test was performed to determine if significant differences occur in pelvic measurements among different groups of surgical complications. This population was found to display a relatively narrow transverse pelviccanal when compared to populations from higher latitudes, which was accompanied by an increase in anteroposterior dimensions of the canal. Some measurements were found to follow expected ecogeographical patterns. Significant differences inthe inlet anteroposterior measurement were found among patients in some surgical complication groups. However, no relationship between pelvic dimensions and patient morbidity was found. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Kolorektale kanker verteenwoordig ‘n stygende gesondheidslas wat Suid-Afrikaanse mans meer algemeen affekteer as vroue. Chirurgiese intervensie, en spesifiek totale mesorektale eksisie (TME), bly ‘n sleutelwyse in die hantering van rektale kanker. Die prosedure vind plaas in die ruimtelik beperkte bekkenkanaal. Die waarneming dat daar ‘n meer ingewikkeldheid ervaar word tydens ‘n TME op Suid-Afrikaanse mans by Tygerberg Akademiese Hospitaal (TH), het tot die indruk geleidat die mans ‘n uitsonderlike vernoude pelvis het. Veelvuldige evolusionêre faktore soos geboorte, termoregulasie en bipedale of tweevoetige voortbeweging, het die grootte van die moderne menslike bekkengordel gevorm, met mans wat ‘n baie nouer bekken toon as vroue. Klimaat is geografies saamgestel en daar word geglo dat dit ‘n belangrike rol speel in pelviese afmetings. Bevolkingsgroepe van ‘n laer breedte graad toon ‘n nouer en dieper bekkengordel in vergelyking met diegene van ‘n hoёr breedte graad. Die primêre doelstelling van die studie was om die afmetings van die bekkengordel in mans van die Wes-Kaap wat potensiёle genesende kolorektale chirurgie by TH ondergaan het, te meet. Dit word dan vergelyk met uitslae van ander eko-geografiese areas. Die tweede doelstelling is om ‘n verwantskap te bepaal tussen pelviese afmetings en morbiditeit wat gedokumenteer is in rektale kanker pasiёnte wat TME ondergaan het by TH. Die bekkengordelgrootte was ondersoek deur 19 pelviese afmetings op 3D benige pelviese rekonstruksies van manlike pasiёnte (n=158) te meet deur die gebruik van gerekenariseerde tomografiese data. Daarna is die afmetings vergelyk met ander eko-geografiese areas, om sodoende die relatiewe pelviese grootte en verhouding tussen breedte graad en pelviese dimensies te ondersoek. Hierdie data is met forest stippings aangedui. Laastens is ‘n een rigting ANOVA met ‘n post hoc Bonferroni toets gedoen om te bepaal of betekenisvolle verskille voorkom in pelviese afmetings tussen verskillende groepe met chirurgiese komplikasies. Hierdie bevolkingsgroep toon ‘n relatiewe nou transversale bekkenkanaal, as dit vergelyk word met hoёr breedte grade, tesame met ‘n verhoogde anteroposterior afmetings van die kanaal. Sekere meetings het verwagte eko-geografiese patrone gevolg. Betekenisvolle verskille was opgemerk in die bekkeninlaat se anteroposterior afmetings in pasiёnte in sekere chirurgiese komplikasie groepe. Daar is egter geen verhouding tussen pelviese afmetings en pasiёnt morbiditeit nie. Die nou dwarsafmetings van die ware pelvis van hierdie populasie in vergelyking met mans van ander eko-geografiese areas kan die moeilikheidsgraad van die TME vergroot tydens chirurgie. Daar is egter geen betekenisvolle verskille in transversale afmetings tussenpasiёnte met of sonder chirurgiese komplikasies gevind nie. Betekenisvolle verskille is gevind in die anteroposterior afmeting van die kanaal, hierdie afmeting was egter groter as in mense van hoёr breedte graad areas. Geen verhouding is gevind tussen pelviese dimensies en chirurgiese komplikasies nie. Hierdie bevindinge hoop om van hulp te wees in identifikasie van pasiёnte wat voordoen met nou bekkengordels voor chirurgie, om pre-operatiewe beplanning te fasiliteer vir n potensiёle moeilike TME. Pasiёnt pelviese afmeting kan vergelyk word met meting van die moeilikheidsgraad van ‘n prosedure vir toekomstige navorsingprojekte. | af_ZA |
| dc.description.version | Masters | en_ZA |
| dc.format.extent | 87 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/109238 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Pelvimetry -- Males | en_ZA |
| dc.subject | Rectal Cancer | en_ZA |
| dc.subject | Total mesorectal excision | en_ZA |
| dc.subject | UCTD | en_ZA |
| dc.subject | Cancer -- Surgery | en_ZA |
| dc.title | Pelvimetry of Males from the Western Cape with Rectal Cancer: Anatomical and Clinical Implication | en_ZA |
| dc.type | Thesis | en_ZA |