Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results
Objective: comparative assessment of long-term oncological results of laparoscopic extralevator and traditional abdominal-perineal resection (APR).Materials and methods. The analysis of immediate and long-term oncological results of treatment of 92 patients who underwent traditional laparoscopic and...
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| Format: | Article |
| Language: | Russian |
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“ABV-press” Publishing house”, LLC
2020-12-01
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| Series: | Тазовая хирургия и онкология |
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| Online Access: | https://ok.abvpress.ru/jour/article/view/482 |
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| author | M. A. Danilov A. V. Leontyev A. B. Baychorov Z. M. Abdulatipova G. G. Saakyan |
| author_facet | M. A. Danilov A. V. Leontyev A. B. Baychorov Z. M. Abdulatipova G. G. Saakyan |
| author_sort | M. A. Danilov |
| collection | DOAJ |
| description | Objective: comparative assessment of long-term oncological results of laparoscopic extralevator and traditional abdominal-perineal resection (APR).Materials and methods. The analysis of immediate and long-term oncological results of treatment of 92 patients who underwent traditional laparoscopic and extralevator APR for low rectal cancer. Inclusion criteria were tumors of the lower ampullar rectum, excluding the performance of sphincter-sparing surgical interventions, and patients’ age up to 75 years. Exclusion criteria: distant metastases, histologically confirmed squamous cell carcinoma. Analysis of immediate and long-term results was carried out.Results. The main group included patients who underwent extralevator APR (n = 62), patients in the control group (n = 30) underwent traditional APR. There were no significant differences in the type of neoadjuvant and adjuvant treatment in the comparison groups (p >0.05). In the group of patients operated on in the volume of extralevator APR, 42 received neoadjuvant chemoradiotherapy versus 19 patients in the group of traditional APR, there was no statistically significant difference (p = 0.21). In the extralevator APR group, perineal plastic surgery was performed significantly more often than in the traditional APR group (p = 0.001). When evaluating the immediate results, there was a statistically significant difference in the total number of complications between the study groups, such complications as bladder dysfunction following after surgery, inflammatory pelvic disease in the perineal wound, perineal hernia occurred significantly more often in the traditional APR group than in the extralevator APR group (p >0.05). In terms of overall and disease-free survival, the groups differed statistically significantly: 5-year overall survival in the main group was 90 % versus 62.5 % in the control group (p = 0.03), 5-year disease-free survival in the main group was 98.5 % versus 65 % in the control group, respectively (p = 0.01).Conclusions. Extralevator APR of the rectum is the most radical surgical intervention than with the traditional APR technique due to the lower risk of a positive circumferention resection margin, therefore, reducing the incidence of local recurrence, and as a result, improving overall and disease-free survival rates compared to the traditional technique. |
| first_indexed | 2024-03-12T18:41:32Z |
| format | Article |
| id | doaj.art-2ef10c8f2da44b7dbb55dd0f8547bc67 |
| institution | Directory Open Access Journal |
| issn | 2686-9594 |
| language | Russian |
| last_indexed | 2024-03-12T18:41:32Z |
| publishDate | 2020-12-01 |
| publisher | “ABV-press” Publishing house”, LLC |
| record_format | Article |
| series | Тазовая хирургия и онкология |
| spelling | doaj.art-2ef10c8f2da44b7dbb55dd0f8547bc672023-08-02T07:48:57Zrus“ABV-press” Publishing house”, LLCТазовая хирургия и онкология2686-95942020-12-01103-4344210.17650/2686-9594-2020-10-3-4-34-42349Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term resultsM. A. Danilov0A. V. Leontyev1A. B. Baychorov2Z. M. Abdulatipova3G. G. Saakyan4A. S. Loginov Moscow Clinical Scientific Center of the Moscow Healthcare DepartmentA. S. Loginov Moscow Clinical Scientific Center of the Moscow Healthcare DepartmentA. S. Loginov Moscow Clinical Scientific Center of the Moscow Healthcare DepartmentA. S. Loginov Moscow Clinical Scientific Center of the Moscow Healthcare DepartmentA. S. Loginov Moscow Clinical Scientific Center of the Moscow Healthcare DepartmentObjective: comparative assessment of long-term oncological results of laparoscopic extralevator and traditional abdominal-perineal resection (APR).Materials and methods. The analysis of immediate and long-term oncological results of treatment of 92 patients who underwent traditional laparoscopic and extralevator APR for low rectal cancer. Inclusion criteria were tumors of the lower ampullar rectum, excluding the performance of sphincter-sparing surgical interventions, and patients’ age up to 75 years. Exclusion criteria: distant metastases, histologically confirmed squamous cell carcinoma. Analysis of immediate and long-term results was carried out.Results. The main group included patients who underwent extralevator APR (n = 62), patients in the control group (n = 30) underwent traditional APR. There were no significant differences in the type of neoadjuvant and adjuvant treatment in the comparison groups (p >0.05). In the group of patients operated on in the volume of extralevator APR, 42 received neoadjuvant chemoradiotherapy versus 19 patients in the group of traditional APR, there was no statistically significant difference (p = 0.21). In the extralevator APR group, perineal plastic surgery was performed significantly more often than in the traditional APR group (p = 0.001). When evaluating the immediate results, there was a statistically significant difference in the total number of complications between the study groups, such complications as bladder dysfunction following after surgery, inflammatory pelvic disease in the perineal wound, perineal hernia occurred significantly more often in the traditional APR group than in the extralevator APR group (p >0.05). In terms of overall and disease-free survival, the groups differed statistically significantly: 5-year overall survival in the main group was 90 % versus 62.5 % in the control group (p = 0.03), 5-year disease-free survival in the main group was 98.5 % versus 65 % in the control group, respectively (p = 0.01).Conclusions. Extralevator APR of the rectum is the most radical surgical intervention than with the traditional APR technique due to the lower risk of a positive circumferention resection margin, therefore, reducing the incidence of local recurrence, and as a result, improving overall and disease-free survival rates compared to the traditional technique.https://ok.abvpress.ru/jour/article/view/482rectal cancerextralevator abdomino-perineal resectionneoadjuvant chemoradiotherapy |
| spellingShingle | M. A. Danilov A. V. Leontyev A. B. Baychorov Z. M. Abdulatipova G. G. Saakyan Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results Тазовая хирургия и онкология rectal cancer extralevator abdomino-perineal resection neoadjuvant chemoradiotherapy |
| title | Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results |
| title_full | Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results |
| title_fullStr | Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results |
| title_full_unstemmed | Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results |
| title_short | Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results |
| title_sort | laparoscopic extralevator abdominoperineal extirpation of the rectum long term results |
| topic | rectal cancer extralevator abdomino-perineal resection neoadjuvant chemoradiotherapy |
| url | https://ok.abvpress.ru/jour/article/view/482 |
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