Short-term outcomes of an extralevator abdominoperineal resection in the prone position compared with a conventional abdominoperineal resection for advanced low rectal cancer

The early experience at a single institution

Seungwan Park, Hyuk Hur, Byung Soh Min, Namkyu Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR. Methods: Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts. Results: Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8%) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3%) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2%) and 6 patients (46.2%) had postoperative complications, and 8 (66.7%) and 2 patients (33.4%) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1%] vs. 3 of 26 [11.5%]). Conclusion: The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.

Original languageEnglish
Pages (from-to)12-19
Number of pages8
JournalAnnals of Coloproctology
Volume32
Issue number1
DOIs
Publication statusPublished - 2016 Feb 1

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Prone Position
Rectal Neoplasms
Carcinoembryonic Antigen
Medical Electronics
Colorectal Neoplasms
Demography
Databases

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

@article{ebaee501ed964f0bb2217b9bba0b2ef9,
title = "Short-term outcomes of an extralevator abdominoperineal resection in the prone position compared with a conventional abdominoperineal resection for advanced low rectal cancer: The early experience at a single institution",
abstract = "Purpose: This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR. Methods: Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts. Results: Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8{\%}) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3{\%}) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2{\%}) and 6 patients (46.2{\%}) had postoperative complications, and 8 (66.7{\%}) and 2 patients (33.4{\%}) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1{\%}] vs. 3 of 26 [11.5{\%}]). Conclusion: The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.",
author = "Seungwan Park and Hyuk Hur and Min, {Byung Soh} and Namkyu Kim",
year = "2016",
month = "2",
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doi = "10.3393/ac.2016.32.1.12",
language = "English",
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publisher = "Korean Society of Coloproctology",
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TY - JOUR

T1 - Short-term outcomes of an extralevator abdominoperineal resection in the prone position compared with a conventional abdominoperineal resection for advanced low rectal cancer

T2 - The early experience at a single institution

AU - Park, Seungwan

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Kim, Namkyu

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Purpose: This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR. Methods: Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts. Results: Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8%) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3%) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2%) and 6 patients (46.2%) had postoperative complications, and 8 (66.7%) and 2 patients (33.4%) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1%] vs. 3 of 26 [11.5%]). Conclusion: The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.

AB - Purpose: This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR. Methods: Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts. Results: Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8%) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3%) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2%) and 6 patients (46.2%) had postoperative complications, and 8 (66.7%) and 2 patients (33.4%) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1%] vs. 3 of 26 [11.5%]). Conclusion: The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.

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U2 - 10.3393/ac.2016.32.1.12

DO - 10.3393/ac.2016.32.1.12

M3 - Article

VL - 32

SP - 12

EP - 19

JO - Annals of Coloproctology

JF - Annals of Coloproctology

SN - 2287-9714

IS - 1

ER -