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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 3/2014

01-03-2014 | Original Article

Oncological superiority of extralevator abdominoperineal resection over conventional abdominoperineal resection: a meta-analysis

Authors: Ao Huang, Hongchao Zhao, Tianlong Ling, Yingjun Quan, Minhua Zheng, Bo Feng

Published in: International Journal of Colorectal Disease | Issue 3/2014

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Abstracts

Purpose

The oncological superiority, i.e., lower circumferential resection margin (CRM) involvement, lower intraoperative perforation (IOP), and local recurrence (LR) rates, of extralevator abdominoperineal resection (EAPR) over conventional abdominoperineal resection (APR) for rectal cancer is inconclusive. This meta-analysis systematically compared the rates of CRM involvement, IOP, and LR of rectal cancer patients treated by EAPR and APR, respectively.

Methods

An electronic literature search of MEDLINE, EMBASE, and Cochrane Library through May 2013 was performed by two investigators independently to identify studies evaluating the CRM involvement, IOP, and LR rates of EAPR and APR, and search results were cross-checked to reach a consensus. Data was extracted accordingly. A Mantel–Haenszel random effects model was used to calculate the odds ratio (OR) with 95 % confidence intervals (95 % CI).

Results

Six studies with a total of 881 patients were included. Meta-analysis of CRM involvement and IOP data from all six studies demonstrated significant lower CRM involvement (OR, 0.36; 95%CI, 0.23–0.58; P < 0.0001) and IOP (OR, 0.31; 95%CI, 0.12–0.80; P = 0.02) rates of EAPR. Data from four studies also showed that EAPR was associated with a lower LR rate than APR (OR, 0.27; 95%CI, 0.08–0.95; P = 0.04). No differences of between-study heterogeneity or publication bias were seen in any of the meta-analyses.

Conclusions

Extralevator abdominoperineal resection could achieve better CRM involvement outcome and lower IOP and LR rates, demonstrating an oncological superiority over conventional abdominoperineal resection.
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Metadata
Title
Oncological superiority of extralevator abdominoperineal resection over conventional abdominoperineal resection: a meta-analysis
Authors
Ao Huang
Hongchao Zhao
Tianlong Ling
Yingjun Quan
Minhua Zheng
Bo Feng
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 3/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-013-1794-6

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