Therapeutic effect of extralevator abdominoperineal excision in combination with conventional abdominoperineal excision on distal rectal cancer:A Meta-analysis
10.7652/jdyxb201702022
- VernacularTitle:肛提肌外腹会阴联合切除术与传统的腹会阴联合切除术对远端直肠癌患者疗效的Meta分析
- Author:
Bohui SHI
;
Pingli GUO
;
Yu REN
;
Jianjun HE
;
Wuke CHEN
;
Xiaoxia MA
;
Yu YAN
- Keywords:
extralevator abdominoperineal excision;
rectal cancer;
circumferential resection margin;
intraop-erative bowel perforation;
local recurrence
- From:
Journal of Xi'an Jiaotong University(Medical Sciences)
2017;38(2):266-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the short and long-term efficacy of extralevator abdominoperineal excision (ELAPE)vs.conventional abdominoperineal excision (APE)on distal rectal cancer.Methods Relevant studies were identified by search of Medline,EMBASE,and Web of Science published between January 1,2008 and February 28,2015,and included in the systematic review and meta-analysis with Stata software (version 12.0). Results Our Meta-analysis included 14 studies involving 3278 patients,of whom 1843 (56.2%)underwent ELAPE and 1435 (43.8%)underwent APE.Compared with patients undergoing APE,those undergoing ELAPE had a significantly reduced risk of intraoperative bowel perforation (IBP)involvement (OR=0 .55 ,95% CI= 0 .37-0 .85 ),but no significant reduction in the occurrence of CRM positivity (OR=0 .81 ,95% CI=0 .52-1 .25 ), local recurrence (LR)(OR=0.49,95% CI=0.18-1.30),wound complications (WCs)(OR=0.93,95% CI=0.65-1.35)or in-hospital death (IHD)(OR=0.89,95% CI=0.47-1.71).Conclusion ELAPE can reduce the risk of IBP but not for CRM positivity or LR when compared with APE.Therefore,more higher-quality studies are needed to verify the short-and long-term effects of ELAPE procedure on distal rectal cancer.
