Laparoscopic extralevator abdominoperineal excision of the rectum: short-term outcomes of a prospective case series

Background Laparoscopic approaches for the resection of low rectal cancer and the extralevator technique for abdominoperineal excision are both becoming increasingly popular. There are little published data regarding the combined application of these techniques to the resection of low rectal tumours...

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Bibliographic Details
Published in:Techniques in coloproctology 2014-05, Vol.18 (5), p.445-451
Main Authors: Kipling, S. L., Young, K., Foster, J. D., Smart, N. J., Hunter, A. E., Cooper, E., Francis, N. K.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Abdominal Surgery
Aged
Aged, 80 and over
Colorectal Surgery
Digestive System Surgical Procedures - adverse effects
Digestive System Surgical Procedures - methods
Disease-Free Survival
Female
Gastroenterology
Humans
Laparoscopy - adverse effects
Laparoscopy - methods
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Perineum - surgery
Postoperative Complications
Proctology
Prospective Studies
Rectal Neoplasms - surgery
Rectum - surgery
Surgery
Treatment Outcome
United Kingdom
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Summary:Background Laparoscopic approaches for the resection of low rectal cancer and the extralevator technique for abdominoperineal excision are both becoming increasingly popular. There are little published data regarding the combined application of these techniques to the resection of low rectal tumours. The aim of this study was to assess the feasibility of such an approach and to appraise short-term outcomes in a consecutive series of patients undergoing laparoscopic extralevator abdominoperineal excision (ELAPE). Methods Consecutive patients undergoing laparoscopic ELAPE at our institution between 2008 and 2011 were identified from a prospectively maintained database. The abdominal phase of the operation was performed laparoscopically, and following extralevator resection, the perineum was reconstructed using a biologic mesh. All patients were enrolled in an enhanced recovery programme. Results Of 166 patients undergoing radical resection of rectal cancer at our institution between 2008 and 2011, 28 underwent laparoscopic ELAPE. Median age was 70 years, median body mass index was 27.5 kg/m 2 , and 71 % were male. The conversion rate to laparotomy was 18 %. Three patients (10.8 %) had circumferential resection margins
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-013-1071-2