Background: Rectal cancer treatment has been dramatically improved during the
last two decades in terms of a lower local recurrence rate and prolonged
survival. This improvement was achieved mainly due to a better surgical
technique (implementation of a total mesorectal excision-TME) and neoadjuvant
chemo and radio therapy. A more radical approach to abdominoperineal
excision, extralevator abdominoperineal excision technique in the prone
Jackknife position, may improve the oncological outcome. The aim of this
study is to show our early experience by using extralevator abdominoperineal
excision. Methods: Extralevator abdominoperineal excision has been used
routinely at Oncology Institute of Vojvodina since 2011. In the last 23
months, we had 11 operations. Clinical and pathological data were obtained
from operative protocols, histopathological data and patients? medical
history. Results: An audit of results showed reduced rate of intra-operative
perforations and circumferential resection margin involvement. Late
postoperative complications have occurred in two patients, sexual dysfunction
in one and pelvic pain in the other. The follow up period is too short (min 2
months, max 23 months, median 8 months) for analysis of local recurrence.
Conclusion: Extralevator abdominoperineal excision, with the emphasis on the
perienal dissection and prone Jackknife position, may help achieve the goals
of radical resections for low rectal cancer. This technique could be
associated with less intra-operative perforations and circumferential
resection margin involvement.
Circumferential Resection Margin Involvement in Stage III Rectal Cancer Patients Treated with Curative Resection Followed by Chemoradiotherapy: A Surrogate Marker for Local Recurrence?
