AIM: The study aimed to compare recent reports on standard and alternative methods of abdominoperineal excision for low rectal cancer regarding the rates of circumferential resection margin involvement and intra-operative bowel perforation. METHOD: Data on rates of margin involvement and perforation were obtained from eight recently published reports and also from a prospective registry of resections at Concord Hospital. Rates of these outcomes and their 95% confidence intervals were evaluated. RESULTS: There was no evidence that extralevator abdominoperineal excision yielded significantly lower rates of resection margin involvement or intra-operative bowel perforation compared with standard abdominoperineal excision in six independent hospital- and population-based patient series. Abdominosacral resection of the rectum, on the other hand, did show significantly lower rates of these endpoints, albeit in selected patients. CONCLUSION: The role of extralevator abdominoperineal excision and abdominosacral resection of the rectum should be investigated further in randomized controlled trials.
AIM: The study aimed to compare recent reports on standard and alternative methods of abdominoperineal excision for low rectal cancer regarding the rates of circumferential resection margin involvement and intra-operative bowel perforation. METHOD: Data on rates of margin involvement and perforation were obtained from eight recently published reports and also from a prospective registry of resections at Concord Hospital. Rates of these outcomes and their 95% confidence intervals were evaluated. RESULTS: There was no evidence that extralevator abdominoperineal excision yielded significantly lower rates of resection margin involvement or intra-operative bowel perforation compared with standard abdominoperineal excision in six independent hospital- and population-based patient series. Abdominosacral resection of the rectum, on the other hand, did show significantly lower rates of these endpoints, albeit in selected patients. CONCLUSION: The role of extralevator abdominoperineal excision and abdominosacral resection of the rectum should be investigated further in randomized controlled trials.
Authors: D L H Baird; C Simillis; C Kontovounisios; Q Sheng; S Nikolaou; W L Law; S Rasheed; P P Tekkis Journal: Tech Coloproctol Date: 2017-09-11 Impact factor: 3.781
Authors: S L Kipling; K Young; J D Foster; N J Smart; A E Hunter; E Cooper; N K Francis Journal: Tech Coloproctol Date: 2013-10-01 Impact factor: 3.781
Authors: J Baral; M R Schön; R Ruppert; H Ptok; J Strassburg; P Brosi; M E Kreis; A Lewin; J Sauer; S Sawicki; L Schiffmann; G Winde; T Junginger; S Merkel; P Hermanek Journal: Chirurg Date: 2015-12 Impact factor: 0.955