Advantage of extralevator abdominoperineal excision comparing to the conventional abdominoperineal excision for low rectal cancer: a Meta-analysis
10.11817/j.issn.1672-7347.2017.03.014
- VernacularTitle:经肛提肌外腹会阴联合切除术与传统腹会阴联合切除术在低位直肠癌根治术中优越性比较的Meta分析
- Author:
Qi WANG
;
Chengwen XU
;
Jiajia WANG
;
Quan REN
;
Jiaqing CAO
- Keywords:
lower rectal caner;
extralevator abdominoperineal excision;
conventional abdominoperineal excision;
perforation;
circumferential resection margin
- From:
Journal of Central South University(Medical Sciences)
2017;42(3):320-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Whether extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial.Systematic review of all comparative studies to define the superiority of ELAPE to conventional abdominoperineal excision (APE).Methods:Corresponding data,with case-control studies or cohorts regarding intraoperative perforation rate,the local recurrence rate and postoperative complications in the ELAPE group and the APE group,were retrieved from PubMed,Embase,the Cochrane Library,Chinese Biomedical Literature (CMB),VIP,China National Knowledge Infrastructure (CNKI),and Wanfang Database.Meta-analysis was performed by using RenMan 5.2.Results:A total of 10 articles were included.Intraperative perforation rate (MD=0.54,95％ CI 0.31 to 1.39,P=0.03),local recurrence rate (MD=0.30,95％ CI 0.21 to 0.42,P＜0.001) in the ELAPE group was significantly lower than that in the APE group.The difference in positive margin rate between the 2 groups was not statistically significant (P=0.07).Conclusion:Through gap repair of episiotomy and individualized therapy can improve ELAPE postoperative quality of life.ELAPE shows certain advantages in treating lower rectal cancer comparing to APE,but it should pay attention to individualized treatment.More studies through large sample multi-center,medium and long term randomized design are necessary to determine the effect of surgery on tumor.
