Circumferential resection margins and perineal complications after neoadjuvant long-course chemoradiotherapy followed by extralevator abdominoperineal excision of the rectum: Five years of activity at a single institution.
J Surg Oncol
; 114(1): 86-90, 2016 Jul.
Article
in En
| MEDLINE
| ID: mdl-27076410
ABSTRACT
BACKGROUND:
Prone extralevator abdominoperineal excision of the rectum (ELAPE) has been introduced to improve the circumferential resection margins (CRM) compared with traditional APER.OBJECTIVE:
We present short-term results achieved with prone ELAPE preceded by neoadjuvant chemoradiotherapy during the last 5 years of activity.DESIGN:
A retrospective review was conducted. SETTINGS AND PATIENTS Prone ELAPE operations performed between September 2010 and August 2014 at Leicester Royal Infirmary preceded by neoadjuvant chemoradiotherapy. INTERVENTIONS AND MAIN OUTCOMEMEASURES:
Data regarding demographics, staging, neoadjuvant therapies, intraoperative perforations, and perineal complications were collected.RESULTS:
Seventy-two patients were included. Pretreatment radiological T4 were 25.0%, histological T4 2.8%. Intraoperative perforations occurred in 2.8%, CRM was involved in 11.1%. Perineal complications consisted of superficial wound infections (20.8%), full thickness dehiscences (16.7%), hematomas (9.7%), pelvic collections (6.9%), and perineal hernias (5.6%).CONCLUSIONS:
In our experience, prone ELAPE preceded by long-course chemoradiotherapy has been successfully used in the last 5 years to resect low rectal tumors. Perineal wound complications rates are similar to those presented in series using direct perineal closures. J. Surg. Oncol. 2016;11486-90. © 2016 Wiley Periodicals, Inc.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
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Rectal Neoplasms
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Rectum
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Adenocarcinoma
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Neoadjuvant Therapy
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Chemoradiotherapy, Adjuvant
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Margins of Excision
Type of study:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
J Surg Oncol
Year:
2016
Document type:
Article
Affiliation country:
United kingdom