Negoi Ionut, Hostiuc Sorin, Paun Sorin, Negoi Ruxandra I, Beuran Mircea
General Surgery Department, Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu Street, Sector 2, 020021, Bucharest, Romania; General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania.
General Surgery Department, Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu Street, Sector 2, 020021, Bucharest, Romania; National Institute of Legal Medicine Mina Minovici, Bucharest, Romania.
Am J Surg. 2016 Sep;212(3):511-26. doi: 10.1016/j.amjsurg.2016.02.022. Epub 2016 May 11.
The aim of this study was to compare the short-term morbidity and long-term oncologic benefits of extralevator abdominoperineal excision (ELAPE) with conventional abdominoperineal resection (CAPR) for patients with rectal cancer.
Electronic search of the Cochrane Library, MEDLINE, EMBASE, Korean Journal, and J-EAST database from 2007 until August 2015 was carried out. We considered randomized controlled trials and nonrandomized comparative studies comparing ELAPE with CAPR to be eligible, if they included patients with rectal cancers.
A total of 1 randomized controlled trials and 10 nonrandomized comparative studies met the inclusion criteria, involving 1,736 patients in the ELAPE group and 1,320 in the CAPR group. The ELAPE was associated with a significantly lower intraoperative perforation rate. There were no differences regarding the circumferential margin involvement, R0 resections, and local recurrence rate. There was less blood loss in ELAPE patients.
The ELAPE significantly lowered the intraoperative perforation rate, with no benefits regarding circumferential resection margin involvement and local recurrence rate.
本研究旨在比较直肠癌患者行提肛外腹会阴联合切除术（ELAPE）与传统腹会阴联合切除术（CAPR）的短期发病率和长期肿瘤学获益。
对2007年至2015年8月期间的Cochrane图书馆、MEDLINE、EMBASE、韩国期刊和J-EAST数据库进行电子检索。如果研究纳入了直肠癌患者，我们认为比较ELAPE与CAPR的随机对照试验和非随机对照研究符合纳入标准。
共有1项随机对照试验和10项非随机对照研究符合纳入标准，ELAPE组有1736例患者，CAPR组有1320例患者。ELAPE的术中穿孔率显著降低。在环周切缘受累、R0切除和局部复发率方面没有差异。ELAPE患者的失血量较少。
ELAPE显著降低了术中穿孔率，但在环周切缘受累和局部复发率方面没有获益。
