<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03806244</url>
  </required_header>
  <id_info>
    <org_study_id>18-002</org_study_id>
    <nct_id>NCT03806244</nct_id>
  </id_info>
  <brief_title>Feasibility of Stereotactic Navigation in Laparoscopic Surgery for Colorectal Cancer</brief_title>
  <acronym>PELVINAV</acronym>
  <official_title>Prospective Study of the Feasibility of Stereotactic Navigation in Laparoscopic Surgery for Colorectal Cancer</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>IHU Strasbourg</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>IHU Strasbourg</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      To evaluate the feasibility and precision of stereotaxic navigation in laparoscopic surgery&#xD;
      for colorectal cancer.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      -  In minimally invasive surgery, the proper identification of the correct anatomical&#xD;
           planes can be difficult due to a lack of tactile feedback and the inability to manually&#xD;
           palpate the organ prior to resection. Although this can be minimized by careful&#xD;
           preoperative planning, the information that can be obtained by images is also of limited&#xD;
           utility. Conventional imaging, such as magnetic resonance imaging (MRI) and computed&#xD;
           tomography (CT-scan), can provide a detailed view of 2D or 3D internal anatomical&#xD;
           structures. However, during surgery, surgeons still have to use their subjective&#xD;
           interpretation to translate this information into three-dimensional spatial&#xD;
           relationships (ie the patient's actual volume). For this reason, in order to perform&#xD;
           adequate resection and avoid injury, the surgeon must constantly infer what is the&#xD;
           actual location of the anatomical structures and what is the position of the surgical&#xD;
           instruments in relation thereto.&#xD;
&#xD;
        -  The proposed study aims to evaluate the feasibility of surgical navigation in patients&#xD;
           with colorectal cancer (sigmoid rectum-right-left rectum) and measure its performance in&#xD;
           the perspective of a more specific application to rectal cancer approached&#xD;
           laparoscopically through the abdomen and / or the anus. The study is proposed to&#xD;
           patients with cancer because the measurement of accuracy will be done on predefined&#xD;
           anatomical points that will be detectable in the surgical field after oncologic&#xD;
           dissection. Benign pathologies do not require this type of extensive dissection and the&#xD;
           application of navigation would imply additional risks for patients.&#xD;
&#xD;
        -  Surgical navigation will be performed on the basis of preoperative images or&#xD;
           intraoperative images.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">July 17, 2019</start_date>
  <completion_date type="Anticipated">July 2023</completion_date>
  <primary_completion_date type="Anticipated">April 2023</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Prevention</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Accuracy of Surgical stereotactic navigation defined as the distance, in millimetres, between the position of the surgical landmark and the position determined by the navigation system</measure>
    <time_frame>up to 7 days post procedure</time_frame>
    <description>Measurement of &quot;accuracy&quot; of surgical navigation defined as the distance measured between the position of &quot;surgical&quot; previously defined anatomical landmarks, pointed with a surgical instrument tracked by the navigation system, and corresponding location of the instrument in the navigation image. A distance equal to or less than 4 mm between the two locations will be considered as an optimum accuracy.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Comparison, in millimeters, of the surgical navigation &quot;accuracy&quot; (as defined in the primary outcome) with or without intraoperative images acquisition</measure>
    <time_frame>up to 7 days post procedure</time_frame>
    <description>Usefulness of intraoperative images acquisition for the registration process of the navigation system by comparing accuracy of surgical navigation (in mm) with or without intraoperative images acquisition</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Difference, in millimetres, between the alignment of the geometric position of the markers in the image space and the actual physical space for stereotaxic navigation</measure>
    <time_frame>up to 7 days post procedure</time_frame>
    <description>Measurement of &quot;registration error&quot; during surgical navigation defined as the difference between the alignment of the geometric position of the markers in the image space and the actual physical space, with or without intraoperative images acquisition. An error of 2 mm during the recording process will be considered as the optimal parameter</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Measurement of the overall operating time (in minutes) with and without intraoperative images acquisition</measure>
    <time_frame>up to 30 days post procedure</time_frame>
    <description>Evaluation of the impact of the introduction of surgical navigation on the operating time. The measurement of the overall operating time (expressed in minutes), associated with surgical navigation</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Measurement of the level of radiation exposure to ionizing factors with and without intraoperative images acquisition</measure>
    <time_frame>up to 30 days post procedure</time_frame>
    <description>Evaluation of the impact of the introduction of surgical navigation on the exposure of the patient to ionizing radiation, measured with Dose Length Product (DLP) and expressed in mGy * cm</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of intra and/or postoperative complication</measure>
    <time_frame>up to 30 days post procedure</time_frame>
    <description>Evaluation of the impact of the introduction of surgical navigation on the incidence of intra- and / or postoperative complications associated with surgical navigation</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">20</enrollment>
  <condition>Colorectal Cancer</condition>
  <arm_group>
    <arm_group_label>PREOP</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>Navigation without intraoperative acquisition of images: Use of conventional preoperative images (CT-MRI) to establish intraoperative navigation.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>PEROP</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Navigation with intraoperative acquisition of images: Intraoperative acquisition (robotic c-Arm) of images to establish intraoperative navigation.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Intraoperative acquisition (robotic c-Arm) of images</intervention_name>
    <description>Conventional laparoscopic colorectal oncologic resection is performed. During the procedure, the operator will identify previously defined anatomical landmarks, point them with an instrument tracked by the navigation system and the accuracy of the stereotactic navigation system will be calculated by comparing the &quot;surgical&quot; anatomical point and its correspondent on the images of the navigation platform.</description>
    <arm_group_label>PEROP</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          1. Patient is over 18 years old&#xD;
&#xD;
          2. Patient presents with cancer&#xD;
&#xD;
          3. Patient has no contraindication to anesthesia and surgical resection&#xD;
&#xD;
          4. Patient able to receive and understand information about the study and give written&#xD;
             informed consent&#xD;
&#xD;
          5. Patient (s) affiliated to the national social security system.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. Patient operated on urgently.&#xD;
&#xD;
          2. Pregnant or lactating patient&#xD;
&#xD;
          3. Patient in an exclusion period (determined by previous or current study).&#xD;
&#xD;
          4. Patient under the protection of justice.&#xD;
&#xD;
          5. Patient under guardianship or curatorship.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Didier Mutter, MD, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Service Chirurgie Digestive et Endocrinienne, Nouvel Hôpital Civil de Strasbourg</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Armelle Takeda, PhD</last_name>
    <phone>+33(0)390413608</phone>
    <email>armelle.takeda@chru-strasbourg.fr</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Bernard Dallemagne, MD</last_name>
    <email>bernard.dallemagne@ircad.fr</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Service de Chirurgie Digestive et Endocrinienne, NHC</name>
      <address>
        <city>Strasbourg</city>
        <zip>67 091</zip>
        <country>France</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Didier Mutter, MD, PhD</last_name>
      <phone>+33(0)3 69 55 05 53</phone>
      <email>didier.mutter@chru-strasbourg.fr</email>
    </contact>
  </location>
  <location_countries>
    <country>France</country>
  </location_countries>
  <link>
    <url>http://adsabs.harvard.edu/abs/2016SPIE.9786E..2LN</url>
    <description>Image-guided navigation surgery for pelvic malignancies using electromagnetic tracking - Proceedings of the SPIE</description>
  </link>
  <link>
    <url>https://core.ac.uk/download/pdf/82477249.pdf</url>
    <description>The use of image guided navigation tracking systems for endoscopic sinus surgery and skull base surgery : a review</description>
  </link>
  <link>
    <url>https://doi.org/10.1053/j.oto.2017.09.010</url>
    <description>Stereotactic Navigation in Complex Spinal Surgery: Tips and Tricks</description>
  </link>
  <reference>
    <citation>Marley AR, Nan H. Epidemiology of colorectal cancer. Int J Mol Epidemiol Genet. 2016 Sep 30;7(3):105-114. eCollection 2016.</citation>
    <PMID>27766137</PMID>
  </reference>
  <reference>
    <citation>Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017 Apr;66(4):683-691. doi: 10.1136/gutjnl-2015-310912. Epub 2016 Jan 27.</citation>
    <PMID>26818619</PMID>
  </reference>
  <reference>
    <citation>Biondi A, Vacante M, Ambrosino I, Cristaldi E, Pietrapertosa G, Basile F. Role of surgery for colorectal cancer in the elderly. World J Gastrointest Surg. 2016 Sep 27;8(9):606-613. doi: 10.4240/wjgs.v8.i9.606.</citation>
    <PMID>27721923</PMID>
  </reference>
  <reference>
    <citation>Simmonds PC, Primrose JN, Colquitt JL, Garden OJ, Poston GJ, Rees M. Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer. 2006 Apr 10;94(7):982-99. doi: 10.1038/sj.bjc.6603033.</citation>
    <PMID>16538219</PMID>
  </reference>
  <reference>
    <citation>Rullier E, Sebag-Montefiore D. Sphincter saving is the primary objective for local treatment of cancer of the lower rectum. Lancet Oncol. 2006 Sep;7(9):775-7. doi: 10.1016/S1470-2045(06)70863-4. No abstract available.</citation>
    <PMID>16945773</PMID>
  </reference>
  <reference>
    <citation>Orsini RG, Wiggers T, DeRuiter MC, Quirke P, Beets-Tan RG, van de Velde CJ, Rutten HJ. The modern anatomical surgical approach to localised rectal cancer. EJC Suppl. 2013 Sep;11(2):60-71. doi: 10.1016/j.ejcsup.2013.07.033. No abstract available.</citation>
    <PMID>26217114</PMID>
  </reference>
  <reference>
    <citation>Abu Gazala M, Wexner SD. Re-appraisal and consideration of minimally invasive surgery in colorectal cancer. Gastroenterol Rep (Oxf). 2017 Feb;5(1):1-10. doi: 10.1093/gastro/gox001. Epub 2017 Feb 6.</citation>
    <PMID>28567286</PMID>
  </reference>
  <reference>
    <citation>Bucholz RD. Introduction to Journal of Image Guided Surgery. J Image Guid Surg. 1995;1(1):1-3. doi: 10.1002/(SICI)1522-712X(1995)1:13.0.CO;2-E. No abstract available.</citation>
    <PMID>9079420</PMID>
  </reference>
  <reference>
    <citation>Azagury DE, Dua MM, Barrese JC, Henderson JM, Buchs NC, Ris F, Cloyd JM, Martinie JB, Razzaque S, Nicolau S, Soler L, Marescaux J, Visser BC. Image-guided surgery. Curr Probl Surg. 2015 Dec;52(12):476-520. doi: 10.1067/j.cpsurg.2015.10.001. Epub 2015 Oct 22. No abstract available.</citation>
    <PMID>26683419</PMID>
  </reference>
  <reference>
    <citation>Mezger U, Jendrewski C, Bartels M. Navigation in surgery. Langenbecks Arch Surg. 2013 Apr;398(4):501-14. doi: 10.1007/s00423-013-1059-4. Epub 2013 Feb 22.</citation>
    <PMID>23430289</PMID>
  </reference>
  <reference>
    <citation>Pruliere-Escabasse V, Coste A. Image-guided sinus surgery. Eur Ann Otorhinolaryngol Head Neck Dis. 2010 Mar;127(1):33-9. doi: 10.1016/j.anorl.2010.02.009. Epub 2010 Mar 24.</citation>
    <PMID>20822755</PMID>
  </reference>
  <reference>
    <citation>Risholm P, Golby AJ, Wells W 3rd. Multimodal image registration for preoperative planning and image-guided neurosurgical procedures. Neurosurg Clin N Am. 2011 Apr;22(2):197-206, viii. doi: 10.1016/j.nec.2010.12.001.</citation>
    <PMID>21435571</PMID>
  </reference>
  <reference>
    <citation>Fitzpatrick JM. The role of registration in accurate surgical guidance. Proc Inst Mech Eng H. 2010;224(5):607-22. doi: 10.1243/09544119JEIM589.</citation>
    <PMID>20718266</PMID>
  </reference>
  <reference>
    <citation>Wittmann W, Wenger T, Zaminer B, Lueth TC. Automatic correction of registration errors in surgical navigation systems. IEEE Trans Biomed Eng. 2011 Oct;58(10):2922-30. doi: 10.1109/TBME.2011.2163156. Epub 2011 Jul 29.</citation>
    <PMID>21803677</PMID>
  </reference>
  <reference>
    <citation>Gundle KR, White JK, Conrad EU, Ching RP. Accuracy and Precision of a Surgical Navigation System: Effect of Camera and Patient Tracker Position and Number of Active Markers. Open Orthop J. 2017 May 31;11:493-501. doi: 10.2174/1874325001711010493. eCollection 2017.</citation>
    <PMID>28694888</PMID>
  </reference>
  <reference>
    <citation>Baumhauer M, Feuerstein M, Meinzer HP, Rassweiler J. Navigation in endoscopic soft tissue surgery: perspectives and limitations. J Endourol. 2008 Apr;22(4):751-66. doi: 10.1089/end.2007.9827.</citation>
    <PMID>18366319</PMID>
  </reference>
  <reference>
    <citation>Wijsmuller AR, Romagnolo LGC, Agnus V, Giraudeau C, Melani AGF, Dallemagne B, Marescaux J. Advances in stereotactic navigation for pelvic surgery. Surg Endosc. 2018 Jun;32(6):2713-2720. doi: 10.1007/s00464-017-5968-0. Epub 2017 Dec 6.</citation>
    <PMID>29214516</PMID>
  </reference>
  <reference>
    <citation>Atallah S, Nassif G, Larach S. Stereotactic navigation for TAMIS-TME: opening the gateway to frameless, image-guided abdominal and pelvic surgery. Surg Endosc. 2015 Jan;29(1):207-11. doi: 10.1007/s00464-014-3655-y. Epub 2014 Jun 28.</citation>
    <PMID>24972925</PMID>
  </reference>
  <reference>
    <citation>Atallah S, Martin-Perez B, Larach S. Image-guided real-time navigation for transanal total mesorectal excision: a pilot study. Tech Coloproctol. 2015 Nov;19(11):679-84. doi: 10.1007/s10151-015-1329-y. Epub 2015 Jul 9.</citation>
    <PMID>26153411</PMID>
  </reference>
  <reference>
    <citation>Atallah S, Larach SW, Monson JR. Stereotactic navigation for TAMIS-TME. Minim Invasive Ther Allied Technol. 2016 Oct;25(5):271-7. doi: 10.1080/13645706.2016.1201119. Epub 2016 Jun 27.</citation>
    <PMID>27348417</PMID>
  </reference>
  <reference>
    <citation>Bai M, Liu B, Mu H, Liu X, Jiang Y. The comparison of radiation dose between C-arm flat-detector CT (DynaCT) and multi-slice CT (MSCT): a phantom study. Eur J Radiol. 2012 Nov;81(11):3577-80. doi: 10.1016/j.ejrad.2011.09.006. Epub 2011 Oct 2.</citation>
    <PMID>21963617</PMID>
  </reference>
  <reference>
    <citation>Raman SP, Chen Y, Fishman EK. Evolution of imaging in rectal cancer: multimodality imaging with MDCT, MRI, and PET. J Gastrointest Oncol. 2015 Apr;6(2):172-84. doi: 10.3978/j.issn.2078-6891.2014.108.</citation>
    <PMID>25830037</PMID>
  </reference>
  <verification_date>August 2022</verification_date>
  <study_first_submitted>January 14, 2019</study_first_submitted>
  <study_first_submitted_qc>January 14, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 16, 2019</study_first_posted>
  <last_update_submitted>August 18, 2022</last_update_submitted>
  <last_update_submitted_qc>August 18, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">August 19, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>stereotactic navigation</keyword>
  <keyword>colorectal cancer</keyword>
  <keyword>laparoscopy</keyword>
  <keyword>transanal surgery</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Colorectal Neoplasms</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03806244
org study id: 18-002
nct id: NCT03806244
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
To evaluate the feasibility and precision of stereotaxic navigation in laparoscopic surgery
      for colorectal cancer.
-  In minimally invasive surgery, the proper identification of the correct anatomical
           planes can be difficult due to a lack of tactile feedback and the inability to manually
           palpate the organ prior to resection. Although this can be minimized by careful
           preoperative planning, the information that can be obtained by images is also of limited
           utility. Conventional imaging, such as magnetic resonance imaging (MRI) and computed
           tomography (CT-scan), can provide a detailed view of 2D or 3D internal anatomical
           structures. However, during surgery, surgeons still have to use their subjective
           interpretation to translate this information into three-dimensional spatial
           relationships (ie the patient's actual volume). For this reason, in order to perform
           adequate resection and avoid injury, the surgeon must constantly infer what is the
           actual location of the anatomical structures and what is the position of the surgical
           instruments in relation thereto.

        -  The proposed study aims to evaluate the feasibility of surgical navigation in patients
           with colorectal cancer (sigmoid rectum-right-left rectum) and measure its performance in
           the perspective of a more specific application to rectal cancer approached
           laparoscopically through the abdomen and / or the anus. The study is proposed to
           patients with cancer because the measurement of accuracy will be done on predefined
           anatomical points that will be detectable in the surgical field after oncologic
           dissection. Benign pathologies do not require this type of extensive dissection and the
           application of navigation would imply additional risks for patients.

        -  Surgical navigation will be performed on the basis of preoperative images or
           intraoperative images.
allocation: Non-Randomized
intervention model: Parallel Assignment
primary purpose: Prevention
masking: None (Open Label)
measure: Accuracy of Surgical stereotactic navigation defined as the distance, in millimetres, between the position of the surgical landmark and the position determined by the navigation system
time frame: up to 7 days post procedure
description: Measurement of "accuracy" of surgical navigation defined as the distance measured between the position of "surgical" previously defined anatomical landmarks, pointed with a surgical instrument tracked by the navigation system, and corresponding location of the instrument in the navigation image. A distance equal to or less than 4 mm between the two locations will be considered as an optimum accuracy.
measure: Comparison, in millimeters, of the surgical navigation "accuracy" (as defined in the primary outcome) with or without intraoperative images acquisition
time frame: up to 7 days post procedure
description: Usefulness of intraoperative images acquisition for the registration process of the navigation system by comparing accuracy of surgical navigation (in mm) with or without intraoperative images acquisition
measure: Difference, in millimetres, between the alignment of the geometric position of the markers in the image space and the actual physical space for stereotaxic navigation
time frame: up to 7 days post procedure
description: Measurement of "registration error" during surgical navigation defined as the difference between the alignment of the geometric position of the markers in the image space and the actual physical space, with or without intraoperative images acquisition. An error of 2 mm during the recording process will be considered as the optimal parameter
measure: Measurement of the overall operating time (in minutes) with and without intraoperative images acquisition
time frame: up to 30 days post procedure
description: Evaluation of the impact of the introduction of surgical navigation on the operating time. The measurement of the overall operating time (expressed in minutes), associated with surgical navigation
measure: Measurement of the level of radiation exposure to ionizing factors with and without intraoperative images acquisition
time frame: up to 30 days post procedure
description: Evaluation of the impact of the introduction of surgical navigation on the exposure of the patient to ionizing radiation, measured with Dose Length Product (DLP) and expressed in mGy * cm
measure: Number of intra and/or postoperative complication
time frame: up to 30 days post procedure
description: Evaluation of the impact of the introduction of surgical navigation on the incidence of intra- and / or postoperative complications associated with surgical navigation
arm group label: PREOP
arm group type: No Intervention
description: Navigation without intraoperative acquisition of images: Use of conventional preoperative images (CT-MRI) to establish intraoperative navigation.
arm group label: PEROP
arm group type: Experimental
description: Navigation with intraoperative acquisition of images: Intraoperative acquisition (robotic c-Arm) of images to establish intraoperative navigation.
intervention type: Other
intervention name: Intraoperative acquisition (robotic c-Arm) of images
description: Conventional laparoscopic colorectal oncologic resection is performed. During the procedure, the operator will identify previously defined anatomical landmarks, point them with an instrument tracked by the navigation system and the accuracy of the stereotactic navigation system will be calculated by comparing the "surgical" anatomical point and its correspondent on the images of the navigation platform.
arm group label: PEROP
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Didier Mutter, MD, PhD
role: Principal Investigator
affiliation: Service Chirurgie Digestive et Endocrinienne, Nouvel Hôpital Civil de Strasbourg
last name: Armelle Takeda, PhD
phone: +33(0)390413608
email: armelle.takeda@chru-strasbourg.fr
last name: Bernard Dallemagne, MD
email: bernard.dallemagne@ircad.fr
facility: 
status: Recruiting
contact: 
country: France
url: http://adsabs.harvard.edu/abs/2016SPIE.9786E..2LN
description: Image-guided navigation surgery for pelvic malignancies using electromagnetic tracking - Proceedings of the SPIE
url: https://core.ac.uk/download/pdf/82477249.pdf
description: The use of image guided navigation tracking systems for endoscopic sinus surgery and skull base surgery : a review
url: https://doi.org/10.1053/j.oto.2017.09.010
description: Stereotactic Navigation in Complex Spinal Surgery: Tips and Tricks
citation: Marley AR, Nan H. Epidemiology of colorectal cancer. Int J Mol Epidemiol Genet. 2016 Sep 30;7(3):105-114. eCollection 2016.
PMID: 27766137
citation: Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017 Apr;66(4):683-691. doi: 10.1136/gutjnl-2015-310912. Epub 2016 Jan 27.
PMID: 26818619
citation: Biondi A, Vacante M, Ambrosino I, Cristaldi E, Pietrapertosa G, Basile F. Role of surgery for colorectal cancer in the elderly. World J Gastrointest Surg. 2016 Sep 27;8(9):606-613. doi: 10.4240/wjgs.v8.i9.606.
PMID: 27721923
citation: Simmonds PC, Primrose JN, Colquitt JL, Garden OJ, Poston GJ, Rees M. Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer. 2006 Apr 10;94(7):982-99. doi: 10.1038/sj.bjc.6603033.
PMID: 16538219
citation: Rullier E, Sebag-Montefiore D. Sphincter saving is the primary objective for local treatment of cancer of the lower rectum. Lancet Oncol. 2006 Sep;7(9):775-7. doi: 10.1016/S1470-2045(06)70863-4. No abstract available.
PMID: 16945773
citation: Orsini RG, Wiggers T, DeRuiter MC, Quirke P, Beets-Tan RG, van de Velde CJ, Rutten HJ. The modern anatomical surgical approach to localised rectal cancer. EJC Suppl. 2013 Sep;11(2):60-71. doi: 10.1016/j.ejcsup.2013.07.033. No abstract available.
PMID: 26217114
citation: Abu Gazala M, Wexner SD. Re-appraisal and consideration of minimally invasive surgery in colorectal cancer. Gastroenterol Rep (Oxf). 2017 Feb;5(1):1-10. doi: 10.1093/gastro/gox001. Epub 2017 Feb 6.
PMID: 28567286
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responsible party type: Sponsor
mesh term: Colorectal Neoplasms
sharing ipd: No