Extended abdominoperineal excision vs. standard abdominoperineal excision in rectal cancer—a systematic overview

Abstract

This systematic review suggests that extended techniques of APE result in superior oncologic outcome as compared to standard techniques.

Pathologie der R1-Klassifikation in der viszeralonkologischen Chirurgie

“…2) durchgeführt. Angaben zum R-Status dürfen in keinem pathologischen Bericht fehlen [36], denn bei inkompletter mesorektaler Exzision ist mit einer signifikant erhöhten Lokalrezidivrate zu rechnen [38].…”

Laparoscopic Surgery for Rectal Cancer: Approaches, Challenges and Outcome

“…These were originally described in open surgery, but more recently these extended resections have been also offered laparoscopically (Georgiou et al, 2009;Stelzner et al, 2011).…”

“…Standard abdominoperineal resection (APR) is well known to be associated with inferior oncological outcomes when compared to anterior resection for low rectal cancer (Stelzner et al, 2011). This is attributed to the relatively high incidence of intra-operative tumour or bowel perforation and positive circumferential resection margin due to the relative lack of the mesorectal fat around the lower rectum (Nagtegaal et al, 2005).…”

“…This technique aims at a wider circumferential resection margin at the level of the tumour bearing segment. Systematic reviews suggests that extended techniques of APR result in superior oncologic outcome in terms of lower incidence of tumour perforation and positive circumferential resection margin when compared to standard techniques (Stelzner et al, 2011).…”

Treatment for cancer of the lower rectal ampulla. State-of-the-art

“…[42] провели систематический анализ результатов лечения 1097 пациентов, которым выполнили расширенную БПЭ и сравнили с результатами 4147 пациентов, оперированных по стандартной методике. Частота интраопера-ционных перфораций и положительного края резекции при рас-ширенной и стандартной БПЭ была 4,1% против 10,4% (относи-тельное снижение риска на 60,6%, p=0,004) и 9,6% против 15,4% (относительное снижение риска на 37,7%, p=0,022).…”