Format

Send to

Choose Destination
J Surg Oncol. 2016 Jul;114(1):86-90. doi: 10.1002/jso.24257. Epub 2016 Apr 13.

Circumferential resection margins and perineal complications after neoadjuvant long-course chemoradiotherapy followed by extralevator abdominoperineal excision of the rectum: Five years of activity at a single institution.

Author information

1
Department of Colorectal Surgery, Leicester Royal Infirmary, Leicester, United Kingdom.
2
Department of Colorectal Surgery, Leicester General Hospital, Leicester, United Kingdom.
3
Department of Radiology, Leicester Royal Infirmary, Leicester, United Kingdom.

Abstract

BACKGROUND:

Prone extralevator abdominoperineal excision of the rectum (ELAPE) has been introduced to improve the circumferential resection margins (CRM) compared with traditional APER.

OBJECTIVE:

We present short-term results achieved with prone ELAPE preceded by neoadjuvant chemoradiotherapy during the last 5 years of activity.

DESIGN:

A retrospective review was conducted.

SETTINGS AND PATIENTS:

Prone ELAPE operations performed between September 2010 and August 2014 at Leicester Royal Infirmary preceded by neoadjuvant chemoradiotherapy.

INTERVENTIONS AND MAIN OUTCOME MEASURES:

Data regarding demographics, staging, neoadjuvant therapies, intraoperative perforations, and perineal complications were collected.

RESULTS:

Seventy-two patients were included. Pretreatment radiological T4 were 25.0%, histological T4 2.8%. Intraoperative perforations occurred in 2.8%, CRM was involved in 11.1%. Perineal complications consisted of superficial wound infections (20.8%), full thickness dehiscences (16.7%), hematomas (9.7%), pelvic collections (6.9%), and perineal hernias (5.6%).

CONCLUSIONS:

In our experience, prone ELAPE preceded by long-course chemoradiotherapy has been successfully used in the last 5 years to resect low rectal tumors. Perineal wound complications rates are similar to those presented in series using direct perineal closures. J. Surg. Oncol. 2016;114:86-90. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

circumferential margin; extralevator abdominoperineal resection; long-course chemoradiotherapy

PMID:
27076410
DOI:
10.1002/jso.24257
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center