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Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer
Shen, Z.; Ye, Y.; Zhang, X.; Xie, Q.; Yin, M.; Yang, X.; Jiang, K.; Liang, B.; Wang, S.
关键词Rectal cancer Extralevator abdominoperineal excision ELAPE
刊名EJSO
2015-04-01
DOI10.1016/j.ejso.2015.01.017
41期:4页:472-477
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology ; Surgery
研究领域[WOS]Oncology ; Surgery
关键词[WOS]EXTRALEVATOR ABDOMINOPERINEAL EXCISION ; COLORECTAL-CANCER ; RESECTION ; SURGERY ; EXPERIENCE ; MULTICENTER ; QUALITY
英文摘要

Background: The use of extra-levator abdominoperineal resection (ELAPE) procedure for lower rectal cancer is controversial. It is unclear whether the ELAPE procedure could improve surgical safety and lead to better oncological outcomes.

Methods: Sixty-nine lower rectal cancer patients who underwent ELAPE (36 cases) or conventional abdominoperineal resection (APE; 33 cases) between June 2011 and February 2013 were prospectively investigated. Clinicopathological variables including blood loss, intraoperative perforation (TOP) rate, circumferential resection margin (CRM) involvement, lymph node harvest, the postoperative complications, urinary and sexual function, quality of life (QOL), local recurrence rate and survival were recorded and compared.

Results: Blood loss (P = 0.021), perineal wound complication (P = 0.039), IOP rate (P = 0.028), local recurrence (P = 0.034) were significantly less frequent in the ELAPE group. There was greater CRM involvement in the conventional APE group but no statistical difference between the two groups. Urinary function, sexual function and QOL were not significantly different between the two groups. Overall survival and progression-free survival were not significantly different between two groups, even when survival was analyzed according to TNM stage, T stage, N stage, and with or without neoadjuvant chemoradiotherapy. In patients who underwent ELAPE there was no statistical difference in postoperative complications between younger and elderly patients (age >= 60).

Conclusions: ELAPE procedure with definitive anatomic landmarks demonstrated surgical safety and decreased local recurrence for lower rectal cancer patients including the elderly, but there were no survival improvements in compared to conventional APE procedure. (C) 2015 Published by Elsevier Ltd.

语种英语
WOS记录号WOS:000353097700007
引用统计
被引频次:8[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/67148
专题北京大学临床肿瘤学院_核医学科
北京大学第二临床医学院_胃肠外科
作者单位Peking Univ, Peoples Hosp, Dept Surg Gastroenterol, Beijing 100044, Peoples R China
推荐引用方式
GB/T 7714
Shen, Z.,Ye, Y.,Zhang, X.,et al. Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer[J]. EJSO,2015,41(4):472-477.
APA Shen, Z..,Ye, Y..,Zhang, X..,Xie, Q..,Yin, M..,...&Wang, S..(2015).Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer.EJSO,41(4),472-477.
MLA Shen, Z.,et al."Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer".EJSO 41.4(2015):472-477.
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