A comparative study of standard versus extralevator abdominoperineal resections

Masimba Nyandowe, Alfred Egedovo, Yik-Hong Ho


Background: The aim was to compare short term outcomes between patients undergoing standard abdominoperineal resection (APR) with those that had an extralevator abdominoperineal excision (ELAPE).

Methods: A retrospective study was done on 123 consecutive patients who underwent an abdominoperineal resection for low rectal cancer at the Townsville hospital between August 2003 and January 2015. Data was collected from medical records.  Short term oncological outcomes were compared between the APR and ELAPE group.

Results: The circumferential resection margin (CRM) involvement rate was significantly lower in the ELAPE group 13.2% versus 19.3% in the APR group. The local recurrence rates in the two groups were not significantly different: 16.8% in the ELAPE versus 17.4% in the APR group. Intraoperative perforations were lower in the ELAPE group 15.3% versus 23.2 % in the APR group. The post-operative wound infection rate was however higher in the ELAPE group 20.3% versus 12.4 % in the APR group.

Conclusions: ELAPE was shown to be superior in the CRM and intraoperative perforation rate but the local recurrence rates were similar. ELAPE had a higher wound complication rate than APR.


Abdominoperineal resection, Extralevator abdominoperineal resections, Outcomes

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