SynthesisChinese medical journal2019
Extralevator abdominoperineal excision versus abdominoperineal excision for low rectal cancer: a meta-analysis.
Synthesis in Chinese medical journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- [Surgery for colorectal cancer in the era of individualized treatment : The new German S3 guideline on colorectal cancer].Chirurgie (Heidelberg, Germany) · 2026Review
- Perineal infection and risk factors following extralevator abdominoperineal excision and reconstruction with an absorbable synthetic prosthesis.Updates in surgery · 2026Observational
- Long-term oncological outcomes of extralevator versus standard abdominoperineal resection with 20 years' experience.Updates in surgery · 2026Article
- Extralevator Abdominoperineal Excision Improves Overall Survival Compared to Standard Abdominoperineal Excision: A Systematic Review and Meta-Analysis.Annals of gastroenterological surgery · 2026Article
- Amide proton transfer-weighted magnetic resonance imaging for predicting histopathology and biomarkers in rectal adenocarcinoma.Quantitative imaging in medicine and surgery · 2026Article
- Fournier's gangrene due to rectal cancer: A case report.Molecular and clinical oncology · 2024Article
- Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease.Radiology case reports · 2023Article
- Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision.Revista do Colegio Brasileiro de Cirurgioes · 2023Article
- Laparoscopic extralevator abdominoperineal excision in distal rectal cancer patients: a retrospective comparative study.BMC surgery · 2022Article
- Surgical Treatment of Low-Lying Rectal Cancer: Updates.Annals of coloproctology · 2021Review
- Perineal wound complication risk factors and effects on survival after abdominoperineal resection of rectal cancer: a single-centre retrospective study.International journal of colorectal disease · 2021Article
- Extralevator abdominoperineal excision for advanced low rectal cancer: Where to go.World journal of gastroenterology · 2020Review
- Selection and Outcomes in Abdominoperineal Resection.Frontiers in oncology · 2020Review
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtralevator abdominoperineal excision (ELAPE) has become a popular procedure for low rectal cancer as compared with abdominoperineal excision (APE). No definitive answer has been achieved whether one is superior to the other. This study aimed to evaluate the safety and efficacy of ELAPE for low rectal cancer with meta-analysis.
methodsThe Web of Science, Cochrane Library, Embase, and PubMed databases before September 2019 were comprehensively searched to retrieve comparative trials of ELAPE and APE for low rectal cancer. Pooled analyses of the perioperative variables, surgical complications, and oncological variables were performed. Odds ratio (OR) and mean differences (MD) from each trial were pooled using random or fixed effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.
resultsThis meta-analysis included 17 studies with 4049 patients, of whom 2248 (55.5%) underwent ELAPE and 1801 (44.5%) underwent APE. There were no statistical differences regarding the circumferential resection margin positivity (13.0% vs. 16.2%, OR = 0.69, 95% CI = 0.42-1.14, P = 0.15) and post-operative perineal wound complication rate (28.9% vs. 24.1%, OR = 1.21, 95% CI = 0.75-1.94, P = 0.43). The ELAPE was associated with lower rate of intraoperative perforation (6.6% vs. 11.3%, OR = 0.50, 95% CI = 0.39-0.64, P < 0.001) and local recurrence (8.8% vs. 20.5%, OR = 0.29, 95% CI = 0.21-0.41, P < 0.001) when compared with APE.
conclusionsThe ELAPE was associated with a reduction in the rate of intra-operative perforation and local recurrence, without any increase in the circumferential resection margin positivity and post-operative perineal wound complication rate when compared with APE in the surgical treatment of low rectal cancer.
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