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International Journal of Colorectal Disease

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01-07-2011 | Original Article

Short-term outcome of extra-levator abdominoperineal excision for rectal cancer

Authors: Sigmar Stelzner, Gunter Hellmich, Clemens Schubert, Erik Puffer, Gunter Haroske, Helmut Witzigmann

Published in: International Journal of Colorectal Disease | Issue 7/2011

Abstract

Background

Extra-levator abdominoperineal excision (ELAPE) has been introduced to avoid oncologic problems encountered with conventional abdominoperineal excision (APE) such as high rates of inadvertent bowel perforation and of positive circumferential resection margin. We compare our short-term results of this new approach with a historic patient cohort.

Patients and methods

From 1997 until 2010, we performed 46 consecutive conventional APE and 28 ELAPE after neoadjuvant therapy with a macroscopically complete resection in the true pelvis. Patient data was prospectively collected in our colorectal tumor database. Patient and tumor characteristics were compared as were the rates of inadvertent bowel perforation, of circumferential margin involvement, and of wound abscesses.

Results

The rates of inadvertent bowel perforation, of circumferential margin involvement, and of wound abscesses were 15.2% vs. 0 (p = 0.04), 4.9% vs. 0 (p = 0.511), and 17.4% vs. 10.7% (p = 0.518), respectively, in the conventional APE vs. ELAPE group.

Conclusion

With a significant reduction of the bowel perforation rate and a reduction of circumferential margin involvement and wound abscess formation, ELAPE improves important surrogate parameters for local recurrence rate and survival.

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Title: Short-term outcome of extra-levator abdominoperineal excision for rectal cancer
Authors: Sigmar Stelzner
Gunter Hellmich
Clemens Schubert
Erik Puffer
Gunter Haroske
Helmut Witzigmann
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 7/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-011-1157-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short-term outcome of extra-levator abdominoperineal excision for rectal cancer

Abstract

Background

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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