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Short-term outcomes of the modified extralevator abdominoperineal resection for low rectal cancer (with videos)

Authors
 Eun Jung Park  ;  Seung Hyuk Baik  ;  Jeonghyun Kang  ;  Hyuk Hur  ;  Byung Soh Min  ;  Kang Young Lee  ;  Nam Kyu Kim  ;  Seung-Kook Sohn 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.30(4) : 1672-1682, 2016 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2016
MeSH
Abdomen/surgery ; Adult ; Aged ; Dissection ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods* ; Length of Stay ; Male ; Middle Aged ; Neoplasm Recurrence, Local/surgery ; Perineum/surgery* ; Postoperative Complications/surgery ; Rectal Neoplasms/surgery* ; Rectum/pathology ; Rectum/surgery* ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods* ; Treatment Outcome
Keywords
Abdominoperineal resection ; Primary closure ; Reconstruction ; Rectal cancer ; Total mesorectal excision
Abstract
Background : Extralevator abdominoperineal resection had oncologic superiority with reduced local recurrence and improving survival rates. However, extended perineal resection resulted in complicated perineal reconstructions. Therefore, a new surgical technique to overcome previous limitations is required. This study aims to demonstrate a surgical procedure and outcomes of the modified extralevator abdominoperineal resection, which satisfies both an extended cylindrical resection and a convenient perineal wound closure by modification of the surgical dissection plane. Methods : From September 2011 to February 2014, 12 consecutive patients (five males and seven females) who underwent the modified extralevator abdominoperineal resection for low rectal cancer were evaluated. Intraoperative and postoperative outcomes were assessed. Pathologic outcomes were evaluated for the oncologic results. Results : The mean age was 55.3 ± 15.1 years, and body mass index was 21.8 ± 3.1 kg/m2. Ten patients (83.3 %) received preoperative chemoradiotherapy. The operations were performed by five cases of laparoscopic surgery, six cases of open surgery and one case of robotic surgery. The mean operation time was 258.8 ± 58.0 min. There were no conversions and no tumor perforations. Days to first soft diet was 4.7 ± 3.4 days, and the mean hospital stay was 11.2 ± 4.7 days. Postoperative complications were two cases of grade I, two cases of grade II and one case of grade III. There was one patient (8.3 %) with a positive circumferential resection margin, and there was one case of local recurrence. Conclusions : The modified extralevator abdominoperineal resection was feasible and safe for patients with low rectal cancer with extended perineal dissection and convenient direct wound closure.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-015-4400-x
DOI
10.1007/s00464-015-4400-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146523
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