Extralevator abdominoperineal excision for low rectal cancer: oncological outcome after five-year follow-up

Keywords: rectal cancer, extralevator abdominoperineal excision, local recurrence, overall survival

Abstract

Background: Extralevator abdominoperineal excision (ELAPE) is a surgical technique that is indicated for low rectal cancer where sphincter preservation is not possible. Compared to conventional abdominoperineal excision major advantages of ELAPE are the risk reduction of intraoperative bowel perforation and positive circumferential margin which lead to a better oncological outcome. The aim of this study was to present our results in ELAPE surgery.

Methods: From February 2011 to February 2015, 40 patients underwent surgery for low rectal cancer at the Oncology Institute of Vojvodina. The collected data included sex, age, preoperative staging, neoadjuvant treatment, operative time, rate of intraoperative bowel perforation, rate of positive circumferential resection margins, histopathological analysis, postoperative mortality, tumour, node and metastasis (TNM) classification, local recurrence (LR) rate and presence of distant metastases.

Results: Positive circumferential margin was found in three (7.5%) patients while eight (20%) patients had intraoperative bowel perforation. LR during follow-up was seen in seven (17.5%) patients, three of them had intraoperative bowel perforation and two patients had positive circumferential margin. The estimated five-year cumulative incidence of LR is 7%. Distant metastases occurred in 18 (45%) patients. The estimated five-year survival rate is 62%.

Conclusion: The study shows satisfactory five-year survival rates of 62% in a highly complex patient group treated by ELAPE procedure.

Author Biographies

A Đermanović, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica, Serbia

Z Radovanović, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica and Faculty of Medicine, University of Novi Sad, Serbia

D Lukić, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica and Faculty of Medicine, University of Novi Sad, Serbia

M Đurić, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica, Serbia

M Kresoja, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica and Faculty of Medicine, University of Novi Sad, Serbia

D Golijanin, Oncology Institute of Vojvodina Sremska Kamenica

Department of Surgical Oncology, Oncology Institute of Vojvodina Sremska Kamenica, Serbia

Published
2021-12-08
How to Cite
Đermanović, A., Radovanović, Z., Lukić, D., Đurić, M., Kresoja, M., & Golijanin, D. (2021). Extralevator abdominoperineal excision for low rectal cancer: oncological outcome after five-year follow-up. South African Journal of Surgery, 59(4), 164-168. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/3418
Section
Colorectal Surgery