Focus on Extralevator Perineal Dissection in Supine Position for Low Rectal Cancer Has Led to Better Quality of Surgery and Oncologic Outcome

Abstract

The objective of surgical treatment of low rectal cancer is to obtain negative resection margins and subsequently reduce the risk of local recurrence. A combination of the appropriate preoperative treatment and standardized surgical technique such as sPPD can achieve this goal.

Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer

“…17,20,21 Our results showed the quality of mesorectal excision of ELAPE procedure was better and the rate of IOP and local recurrence of ELAPE procedure were significantly lower than that of conventional APE procedure, although there was no statistical difference in positive CRM rate, OS and PFS between the two groups. However, no local recurrence occurred in the ELAPE group; all cases with local recurrence in the conventional APE group were T3 stage without preoperative chemoradiotherapy and with positive CRM in 3/5 cases and IOP in 2/5 cases.…”

Variation in circumferential resection margin: Reporting and involvement in the South-Netherlands

“…2 On the other hand, the introduction of new surgical techniques, such as extralevator APE (ELAPE), resulted in less CRM involvement and better oncological outcome in patients with distal rectal cancer. 13,14 Population-based data on CRM reporting and involvement are rare in the available literature. 15 The aim of the current study was to evaluate variation in CRM reporting within different pathology departments and CRM involvement in different hospitals.…”

Extralevator AbdominoPerineal Excision (ELAPE) for Advanced Low Rectal Cancer

“…The data showed a significant difference in positive resection margins compared with historical controls, 6.8 to 2.2% in T1-3 tumors and 30.2 to 5.7% in T4 tumors, following the introduction of the program. Local recurrence rates and overall cancer survival were also shown to improve with the enhanced perineal dissection [39].…”