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Determination of the positional relationship of the second Houston valve and peritoneal reflection using computed tomographic colonography and magnetic resonance imaging

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Abstract

Purpose

The second Houston valve is used as a surrogate for estimating the position of the peritoneal reflection; however, the concordance between the positions of the valve and peritoneal reflection has not been investigated. This study aimed to clarify this positional relationship.

Methods

The second Houston valve and peritoneal reflection positions were assessed using tomographic colonography and magnetic resonance imaging. In total, 117 patients were enrolled in this study.

Results

The positions of the second Houston valve and peritoneal reflection were nearly concordant, although the space between them ranged from − 20.7 to 33.9 mm. A peritoneal reflection located further from the anal verge than the second Houston valve was defined as a shallow peritoneal reflection. Male sex, high body weight, and a high body mass index were significantly correlated with a shallower peritoneal reflection, as determined by a univariate analysis (sex: P = 0.0138, weight: P = 0.0097, body mass index: P = 0.0311). A multivariate analysis revealed a significantly shallower peritoneal reflection in males than in females (odds ratio: 2.75, 95% confidence interval: 1.15–6.56, P = 0.023).

Conclusions

The second Houston valve located near the peritoneal reflection can be a useful surrogate marker for estimating its position. In relatively heavy males, the peritoneal reflection is located more cranially than the second Houston valve.

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Data availability

The data that support the findings of this study are available from the corresponding author, Shin Murai, upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

This research is supported by Grants-in-Aid for Scientific Research (C: grant number; 18K07194, C: grant number; 19K09114, C: grant number; 19K09115, C: grant number; 20K09051, Challenging Research [Exploratory]: grant number; 20K21626) from the Japan Society for the Promotion of Science. This research is supported by the Project for Cancer Research and Therapeutic Evolution, grant number: JP 19cm0106502 from the Japan Agency for Medical Research and Development.

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No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan

    Shin Murai, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Shinya Abe, Yuzo Nagai, Hirofumi Sonoda & Soichiro Ishihara

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  1. Shin Murai
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  2. Kazushige Kawai
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  3. Hiroaki Nozawa
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  4. Kazuhito Sasaki
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  6. Shigenobu Emoto
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  11. Soichiro Ishihara
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analyses were performed by KKK, HZ, KS, KM, SE, YY, SS, YN, HS, and SI. The first draft of the manuscript was written by SM, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shin Murai.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the ethics committee of the University of Tokyo (No. 3252-(10)).

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Informed consent was obtained from all individual participants included in the study.

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Patients gave their informed consent by signature regarding publishing their data and photographs.

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Murai, S., Kawai, K., Nozawa, H. et al. Determination of the positional relationship of the second Houston valve and peritoneal reflection using computed tomographic colonography and magnetic resonance imaging. Surg Today 53, 614–620 (2023). https://doi.org/10.1007/s00595-022-02615-3

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  • DOI: https://doi.org/10.1007/s00595-022-02615-3

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