ArticleInternational journal of colorectal disease2016
Long-term outcome of extralevator abdominoperineal excision (ELAPE) for low rectal cancer.
Article in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Extralevator abdominoperineal excision versus abdominoperineal excision for low rectal cancer: a meta-analysis.Chinese medical journal · 2019Pooled it
- Supine bottom-up extralevator abdominoperineal excision for anorectal adenocarcinoma is not inferior to standard approach and may be thus safely performed.Surgical endoscopy · 2023Article
- Tailored concept for the plastic closure of pelvic defects resulting from extralevator abdominoperineal excision (ELAPE) or pelvic exenteration.International journal of colorectal disease · 2022Article
- Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer.BMC surgery · 2022Article
- Indocyanine Green Near-Infrared Fluoroangiography Is a Useful Tool in Reducing the Risk of Anastomotic Leakage Following Left Colectomy.Frontiers in surgery · 2022Article
- Association of certification, improved quality and better oncological outcomes for rectal cancer in a specialized colorectal unit.International journal of colorectal disease · 2021Observational
- Extralevator abdominoperineal excision for advanced low rectal cancer: Where to go.World journal of gastroenterology · 2020Review
- International evaluation of circumferential resection margins after rectal cancer resection: insights from the Swedish and Dutch audits.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2020Article
- Variation in the Height of Rectal Cancers According to the Diagnostic Modalities.Annals of coloproctology · 2019Article
- Application of modified primary closure of the pelvic floor in laparoscopic extralevator abdominal perineal excision for low rectal cancer.World journal of gastroenterology · 2018Article
- Preliminary Outcome of Individualized Abdominoperineal Excision for Locally Advanced Low Rectal Cancer.Chinese medical journal · 2018Article
- Extralevator versus standard abdominoperineal excision in locally advanced rectal cancer: a retrospective study with long-term follow-up.International journal of colorectal disease · 2018Article
- Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer: A review.World journal of clinical oncology · 2017Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeExtralevator abdominoperineal excision (ELAPE) was introduced to improve outcomes for low-lying locally advanced rectal cancers (LARC) not amenable to sphincter preserving procedures. This study investigates prospectively outcomes of patients operated on with ELAPE compared with a similar cohort of patients operated on with conventional APE.
methodsAfter the exclusion of patients without neoadjuvant therapy, in-hospital mortality, and incomplete metastatectomy, we identified 72 consecutive patients who had undergone either conventional APE (n = 36) or ELAPE (n = 36) for LARC ≤6 cm from the anal verge. The primary outcome measure was local recurrence at 5 years, and secondary outcome measures were cause-specific and overall survival.
resultsMedian distance from the anal verge was significantly lower in the ELAPE group (2 vs. 4 cm, p = 0.029). Inadvertent bowel perforation could be completely avoided in the ELAPE group, but amounted to 16.7 % in the conventional APE group (p = 0.025). Cumulative local recurrence rate at 5 years was 18.2 % in the APE group compared to 5.9 % in the ELAPE group (p = 0.153). Local recurrence without distant metastases occurred in 15.5 % in the APE group but was not observed in the ELAPE group (p = 0.039). We did not detect significant differences in cause-specific nor in overall survival.
conclusionELAPE results in lower local recurrence rates as compared with conventional APE. We conclude that the extralevator approach should be the procedure of choice for advanced low rectal cancer not amenable to sphincter preserving procedures.
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