Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience

CELEP, Bahadır; ELBİR, Orhan Hayri; DEMIRBAG, ALI E.; KAYAALP, Cüneyt; NEŞŞAR, Gürel

Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience

Gürel NEŞŞAR, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastrointestinal Cerrahi Kliniği, Ankara, Türkiye)

Ali Eba DEMİRBAĞ, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastrointestinal Cerrahi Kliniği, Ankara, Türkiye)

Bahadır CELEP, (Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Genel Cerrahisi Anabilim Dalı, Afyon, Türkiye)

Orhan Hayri ELBİR, (Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastrointestinal Cerrahi Kliniği, Ankara, Türkiye)

Cüneyt KAYAALP (İnönü Üniversitesi, Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Malatya, Türkiye)

Ulusal Cerrahi Dergisi

5 0

Yıl: 2016 Cilt: 32 Sayı: 4 Sayfa Aralığı: 244 - 247 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience

Öz:

Amaç: Ekstralevator abdominoperineal eksizyon (ELAPE), rektal kanserde yüksek oranda lokal nüks ve kötü sağkalım sonuçlarına yol açan radyal sınır tutulumu (RST) ve intraoperatif perforasyon (İOP) riskini azaltır. Bu çalışmanın amacı rektum kanserinde ELAPE ile klasik abdominoperineal eksizyonu (APE) karşılaştırmaktır. Gereç ve Yöntemler: Kasım 2008 ile Eylül 2011 arasında rektum kanseri nedeniyle 25 ardışık hastaya ELAPE yapıldı. 2008 yılından önce klasik APE yapılan 56 hastanın kayıtları karşılaştırma amacıyla seçildi.Bulgular: Ortalama takip süresi ELAPE grubunda 44,7 ay, APE grubunda 70,6 aydı. ELAPE yapılan hastalarda APE yapılan hastalara göre daha az RST ve İOP görüldü (sırasıyla, %12 ve %20, p=0,531; %4 ve %8,9, p=0,826). Perine yara komplikasyonları ELAPE grubunda APE grubuna göre daha yüksekti (%16,0 ve %1,8, p=0,030). Her iki grup arasında lokal nüks yönünden anlamlı fark yoktu (%4 ve %3,6, p=1,0).Sonuç: Bu çalışmanın sonuçlarına göre ELAPE tekniğinde klasik cerrahiye göre daha az RST ve İOP görülmekte ancak postoperatif perine komplikasyonları belirgin olarak artmaktadır. ELAPE tekniği ileri evre alt rektum kanserlerinde kullanılmalıdır.

Anahtar Kelime:

Konular: Cerrahi

Alt yerleşimli rektal kanserlerde ekstralevator abdominoperineal eksizyon ile klasik cerrahinin karşılaştırılması: Tek cerrah deneyimi

Öz:

Objective: Extralevator abdominoperineal excision (ELAPE) reduces the risk of positive circumferential resection margin (CRM) and of intraoperative perforation (IOP), both of which are associated with high local recurrence rates and poor survival outcomes for rectal cancer. The aim of this study was to compare the results of ELAPE with conventional abdominoperineal excision (APE) for low rectal cancer.Material and Methods: A total of 25 consecutive patients underwent ELAPE for low rectal cancer between November 2008 and September 2011. Fifty-six patients treated by conventional APE prior to 2008 were selected from our rectal cancer database for comparison as a historical cohort. Results: The mean follow-up was 44.7 months in the ELAPE group, and 70.6 months in the APE group. Patients undergoing ELAPE had a lower CRM positivity and IOP rate than APE (12% vs. 20%, p=0,531; 4% vs. 8,9%, p=0,826; respectively). The ELAPE group was associated with higher perineal wound complications than the APE group (16.0% vs. 1.8%, p=0.030). Local recurrence rates for patients in both groups did not differ significantly (4.0% vs. 3.6%, p=1.0).Conclusion: The results of this study suggest that ELAPE technique was associated with less CRM involvement and reduced rates of IOP but markedly higher rates of postoperative perineal complications occurred as compared to conventional surgery. ELAPE must be reserved for advanced low rectal cancers.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	NEŞŞAR G, DEMIRBAG A, CELEP B, ELBİR O, KAYAALP C (2016). Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. , 244 - 247.
Chicago	NEŞŞAR Gürel,DEMIRBAG ALI E.,CELEP Bahadır,ELBİR Orhan Hayri,KAYAALP Cüneyt Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. (2016): 244 - 247.
MLA	NEŞŞAR Gürel,DEMIRBAG ALI E.,CELEP Bahadır,ELBİR Orhan Hayri,KAYAALP Cüneyt Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. , 2016, ss.244 - 247.
AMA	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. . 2016; 244 - 247.
Vancouver	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. . 2016; 244 - 247.
IEEE	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C "Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience." , ss.244 - 247, 2016.
ISNAD	NEŞŞAR, Gürel vd. "Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience". (2016), 244-247.

APA	NEŞŞAR G, DEMIRBAG A, CELEP B, ELBİR O, KAYAALP C (2016). Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. Ulusal Cerrahi Dergisi, 32(4), 244 - 247.
Chicago	NEŞŞAR Gürel,DEMIRBAG ALI E.,CELEP Bahadır,ELBİR Orhan Hayri,KAYAALP Cüneyt Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. Ulusal Cerrahi Dergisi 32, no.4 (2016): 244 - 247.
MLA	NEŞŞAR Gürel,DEMIRBAG ALI E.,CELEP Bahadır,ELBİR Orhan Hayri,KAYAALP Cüneyt Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. Ulusal Cerrahi Dergisi, vol.32, no.4, 2016, ss.244 - 247.
AMA	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. Ulusal Cerrahi Dergisi. 2016; 32(4): 244 - 247.
Vancouver	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience. Ulusal Cerrahi Dergisi. 2016; 32(4): 244 - 247.
IEEE	NEŞŞAR G,DEMIRBAG A,CELEP B,ELBİR O,KAYAALP C "Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience." Ulusal Cerrahi Dergisi, 32, ss.244 - 247, 2016.
ISNAD	NEŞŞAR, Gürel vd. "Extralevator abdominoperineal excision versus conventional surgery for low rectal cancer: a single surgeon experience". Ulusal Cerrahi Dergisi 32/4 (2016), 244-247.