scholarly journals Abdominoperineal Excision: Technical Challenges in Optimal Surgical and Oncological Outcomes after Abdominoperineal Excision for Rectal Cancer

2017 ◽  
Vol 30 (05) ◽  
pp. 357-367
Author(s):  
Torbjörn Holm
Keyword(s):  
Rectal Cancer ◽  
Local Control ◽  
Anterior Resection ◽  
Abdominoperineal Excision ◽  
Treatment Results ◽  
Anatomical Structures ◽  
Technical Aspects ◽  
Oncological Outcomes ◽  
Increased Risk ◽  
Technical Challenges

AbstractTreatment results in rectal cancer have improved significantly during the recent two decades, but local control and survival after abdominoperineal excision (APE) have not improved to the same degree as that seen after anterior resection (AR). The reason for this is an increased risk of inadvertent bowel perforations and tumor involved margins after APE as compared with AR. The conventional synchronous combined APE has not been a standardized procedure and consequently oncological outcomes have varied considerably between different institutions and in different reports. With the new concept of APE, based on well-defined anatomical structures, the procedure can be categorized as intersphincteric APE, extralevator APE, and ischioanal APE. This article discusses the technical aspects and results from this approach.

Survival and local recurrence after anterior resection and abdominoperineal excision for rectal cancer

1995 ◽  
Vol 21 (6) ◽  
pp. 640-643 ◽  
Author(s):  
Jörg Tschmelitsch ◽  
Peter Kronberger ◽  
Rupert Prommegger ◽  
Gilbert Reibenegger ◽  
Karl Glaser ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
Abdominoperineal Excision

Impact of surgical approach on short‐term oncological outcomes and recovery following low anterior resection for rectal cancer

2019 ◽  
Vol 21 (8) ◽  
pp. 932-942 ◽  
Author(s):  
L. Z. Hyde ◽  
O. Baser ◽  
S. Mehendale ◽  
D. Guo ◽  
M. Shah ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Approach ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Short Term ◽  
Oncological Outcomes

Short-Term Clinical and Oncological Outcomes after Single-Incision Plus One Port Laparoscopic Anterior Resection for Rectal Cancer

2017 ◽  
Vol 35 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Yasumitsu Hirano ◽  
Masakazu Hattori ◽  
Kenji Douden ◽  
Mari Shimada ◽  
Yasuo Hashizume
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Single Incision ◽  
Short Term ◽  
Laparoscopic Anterior Resection ◽  
Oncological Outcomes

scholarly journals Oncological and quality of life outcomes following extralevator versus standard abdominoperineal excision for rectal cancer

2017 ◽  
Vol 99 (5) ◽  
pp. 402-409 ◽  
Author(s):  
D Kamali ◽  
A Sharpe ◽  
A Musbahi ◽  
A Reddy
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Abdominoperineal Excision ◽  
Long Term Effects ◽  
Recurrence Rates ◽  
Oncological Outcomes ◽  
Significant Difference

INTRODUCTION There is increasing and conflicting research debating the oncological benefits of extralevator abdominoperineal excision (ELAPE) compared with standard abdominoperineal excision (SAPE). However, there is very little in the literature on the long-term effects on patients’ wellbeing following the two procedures. The aim of this study was to determine the oncological outcomes and long-term quality of life (QoL) of patients at two hospitals having undergone ELAPE or SAPE. METHODS Consecutive patients with rectal cancer who underwent either ELAPE or SAPE between January 2009 and June 2015 at a single centre were analysed. Oncological outcomes were determined by histology and follow-up imaging. QoL data were obtained prospectively using the QLQ-C30 and QLQ-CR29 questionnaires. RESULTS A total of 48 patients (36 male, 12 female; 27 ELAPE, 21 SAPE) were reviewed. The mean age was 67.4 years and the median follow-up duration was 44 months (range: 6–79 months). Four patients (2 ELAPE, 2 SAPE) developed local recurrence. Rates of distant metastasis were similar (ELAPE: 11%, SAPE: 14%). There was no significant difference in mean global health status score (ELAPE: 77.3, SAPE: 65.3). Impotence was the most frequently reported problem (mean symptom scores of 89.7 and 78.8 for ELAPE and SAPE respectively). CONCLUSIONS This is the largest study with the longest follow-up period that compares QoL after ELAPE with that after SAPE. Although more radical in nature, ELAPE did not demonstrate any significant impact on QoL compared with SAPE. There was no significant difference in long-term oncological outcome between the groups. Impotence remains a significant problem for all patients and they should be well informed of this risk prior to surgery.

scholarly journals Intersphincteric Resection Pushing the Envelope for Sphincter Preservation

2017 ◽  
Vol 30 (05) ◽  
pp. 368-376 ◽  
Author(s):  
Quentin Denost ◽  
Eric Rullier
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Sphincter Preservation ◽  
Intersphincteric Resection ◽  
Technical Aspects ◽  
Oncological Outcomes ◽  
Distal Rectal Cancer ◽  
End Colostomy ◽  
Bowel Continuity ◽  
Restoration Of Bowel Continuity

AbstractDuring the last 15 years, a significant evolution has emerged in the surgical treatment of rectal cancer and restoration of bowel continuity has been one of the main goals. For many years the treatment of distal rectal cancer would necessarily require an abdominoperineal resection and end colostomy. The surgical procedure of intersphincteric resection has been proposed to offer sphincter preservation in patients with low rectal cancer and has been legitimized if executed according to adequate oncologic criteria. This article will discuss the best indications, technical aspects, functional, and oncological outcomes of intersphicteric resection in the management of rectal cancer.

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