SynthesisJournal of surgical oncology2019
Perioperative and oncological outcomes of abdominoperineal resection in the prone position vs the classic lithotomy position: A systematic review with meta-analysis.
Synthesis in Journal of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Excision of a bulky rectal cancer with uterine invasion via a perineal approach in the right lateral decubitus position: a case report.Journal of surgical case reports · 2026Article
- MRI navigation surgery for T4b rectal cancer using multiple minimally invasive surgical approaches.International journal of colorectal disease · 2025Article
- ASO Author Reflections: Advanced Techniques in Robot-Assisted Abdominoperineal Resection.Annals of surgical oncology · 2024Article
- Lithotomy versus prone position for perianal surgery: a randomized controlled trial.Annals of coloproctology · 2022Article
- Advantages of robotic abdominoperineal resection compared with laparoscopic surgery: a single-center retrospective study.Surgery today · 2022Article
- Surgical Treatment of Low-Lying Rectal Cancer: Updates.Annals of coloproctology · 2021Review
- Selection and Outcomes in Abdominoperineal Resection.Frontiers in oncology · 2020Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND
objectivesThis study is a systematic review with meta-analysis designed to compare the perioperative and oncological outcomes of the abdominoperineal resection (APR) carried out in the prone jack-knife position (P-APR) vs the classic lithotomy position (C-APR).
methodsWe conducted an electronic search through PubMed utilizing the PRISMA guidelines. We included all randomized and nonrandomized studies which allowed for comparative analysis between the two groups. Research that focused on and analyzed the extralevator abdominal excision were excluded. Pooled variables and number of events were analyzed using the random-effect model.
resultsThe final analysis included seven nonrandomized retrospective cohorts encompassing 1663 patients. P-APR was associated with decreased operative time (OT) (DM, -43.8 minutes; P < 0.01) and estimated blood loss (EBL) (DM, 86.9 mL; P < 0.01). There were no observed differences regarding perineal wound infections (PWI) (odds ratio [OR], 0.36; P = 0.18), intraoperative perforation of rectum (IOP) (OR, 0.98; P = 0.97), circumferential resection margin (CRM) positivity (OR, 1.02; P = 0.98) or 5-year LR (OR, 1.00; P = 0.99).
conclusionThe prone approach for APR is associated with decreased EBL and OT, although not with any change in the incidence of PWI or IOP. Moreover, surgical positioning per se does not appear to affect the CRM positivity rates or LR rate.
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