Abstract:
PURPOSE:Whether the introduction of extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial. We conducted a systematic review and meta-analysis of all comparative studies to define the efficacy and safety of ELAPE and standard abdominoperineal excision (APE). MATERIALS AND METHODS:A search for all major databases and relevant journals from inception to July 2013 without restriction on languages or regions was performed. Outcome measures were the oncological parameters of circumferential resection margin (CRM) involvement, intraoperative bowel perforation (IOP), and local recurrence, as well as other parameters of blood loss, operative time, length of hospitalization, and postoperative complication. The test of heterogeneity was performed with the Q statistic. RESULTS:A total of 949 patients were included in the meta-analysis. Oncological pooled estimates of intraoperative bowel perforation rate (RR 0.34; 95 % CI 0.21-0.54; P < 0.00001), CRM involvement (RR 0.44; 95 % CI 0.34-0.56; P < 0.00001), and local recurrence (RR 0.32; 95 % CI 0.14-0.74; P = 0.008) all showed outcomes that were significantly lower in ELAPE than in APE. A similar incidence of postoperative complication was attributed to both groups, including overall complication (RR 0.93; 95 % CI 0.66-1.32; P = 0.69), perineal wound complication (RR 0.72; 95 % CI 0.33-1.55; P = 0.39), and urinary dysfunction (RR 1.53; 95 % CI 0.88-2.67; P = 0.13). CONCLUSION:ELAPE has a lower intraoperative bowel perforation rate, positive CRM rate, and local recurrence rate than APE. There is evidence that in selected low rectal cancer patients, ELAPE is a more efficient and equally safe option to replace APE. Due to the inherent limitations of the present study, future randomized controlled trials will be useful to confirm this conclusion.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Yu HC,Peng H,He XS,Zhao RSdoi
10.1007/s00384-013-1793-7subject
Has Abstractpub_date
2014-02-01 00:00:00pages
183-91issue
2eissn
0179-1958issn
1432-1262journal_volume
29pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Current evidence suggests a survival benefit to post-operative surveillance following curative colorectal cancer resection; however, there is still no consensus on the optimal duration and form. OBJECTIVES:The objective is to prospectively audit outcomes of an intensive colorectal cancer follow-up scheme fo...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2356-x
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Our previous study reported that carcinoembryonic antigen (CEA) levels in peritoneal fluid were significantly correlated with the prevalence of peritoneal carcinomatosis (PC) in colorectal cancer (CRC). The purpose of this study was a long-term follow up of the author's previous study, as well as the identifica...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-019-03448-2
更新日期:2020-01-01 00:00:00
abstract::The biomechanical properties and intestinal wall composition of left colon were studied in 4-month-old, 14-month-old, and 27-month-old male rats. The hydroxyproline content and hydroxyproline concentration in old rats were increased by 36% and 26%, respectively, compared with young rats and by 20% and 17%, respectivel...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341292
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:The impact of postoperative complications (POCs) on the long-term prognosis of patients with colorectal carcinoma was analysed with respect to their severity according to the Clavien-Dindo classification (CDC). METHODS:The prospectively collected data of 2158 patients who underwent curative resection of a c...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03557-3
更新日期:2020-06-01 00:00:00
abstract::The function of the striated anal sphincter during defaecation straining was recorded by manometry and electromyography (E.M.G.) in 31 constipated patients who were unable to expel a water-filled rectal balloon with effort. This group was divided on the basis of measurement of colonic diameter into those with megacolo...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01660715
更新日期:1988-11-01 00:00:00
abstract::Colonoscopy is the established method of surveillance of subjects at high risk of developing colorectal neoplasia. Its role in the surveillance of a population at moderate risk is less clear, however, as the procedure is expensive, time consuming and occasionally hazardous. The aim of this study was to estimate by cas...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840100316
更新日期:2001-09-01 00:00:00
abstract::Cryosurgery is one of the palliative treatment options to decrease local symptoms due to rectal carcinoma. A total of 106 patients (aged 45-92 years) underwent palliative cryosurgery for primary rectal cancer. Inclusion criteria were prohibitive surgical risk, unresectability, distant metastases, patient refusal of su...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s003840050206
更新日期:1999-08-01 00:00:00
abstract::It has been suggested that perineal descent causes puborectalis neuropathy. To elucidate this, perineal descent was measured on standard proctograms and prolongation of mean motor unit potential duration was used as the index of denervation of the external sphincter and puborectalis in 9 male and 18 female patients wi...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01648413
更新日期:1986-04-01 00:00:00
abstract:PURPOSE:There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to recta...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-010-1019-1
更新日期:2010-12-01 00:00:00
abstract::A new case of benign lymphoid polyposis of the colon in an adult is presented. Relatively frequent in childhood, this disease remains exceptional in adults. The main concern is differentiation from adenomatous polyposis; the differential diagnosis can be particularly difficult for complex forms of polyposis with coexi...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341239
更新日期:1991-08-01 00:00:00
abstract:PURPOSE:Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2294-7
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Published multigene classifiers suggesting outcome prediction for patients with stage UICC II colon cancer have not been translated into a clinical application so far. Therefore, we aimed at validating own and published gene expression signatures employing methods which enable their reconstruction in routine di...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1176-x
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxi...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-016-2662-y
更新日期:2017-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to prospectively compare rectal resection (RR) with colonic resection on sexual, urinary and bowel function and quality of life in both short-term and long-term. METHODS:Eighty-three patients who underwent RR were compared to 53 patients who underwent a colonic resection leaving t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1288-3
更新日期:2011-12-01 00:00:00
abstract:AIM:Sacral nerve stimulation (SNS) has recently been used in the management of faecal incontinence (FI). This study compared SNS to conservative management with regards to functional and quality of life outcomes. METHODS:Meta-analysis of studies published between 1995 and 2008 on SNS for FI was performed. Outcomes eva...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析
doi:10.1007/s00384-010-1119-y
更新日期:2011-03-01 00:00:00
abstract::A retrospective study of 87 patients, subjected to colostomy closure between 1976 and 1987, was conducted in order to evaluate the role of 8 potential risk factors on morbidity and mortality. Possible risk factors were age greater than 65 years, presence of hypoalbuminaemia (less than 3.0 gr%), anaemia (Hb less than 1...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00298472
更新日期:1990-05-01 00:00:00
abstract:PURPOSE:The introductions of total mesorectal excision and double-stapling technique into colorectal surgery have promoted the clinical application of sphincter preservation. However, for the tumors localized on the middle or lower level of rectum, sphincter-preservation approaches might be problematic in some patients...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-010-0908-7
更新日期:2010-07-01 00:00:00
abstract:PURPOSE:To study the distribution of subtypes and symptoms of fecal incontinence in the general Dutch population. METHODS:We performed a cross-sectional study in a representative sample of the general Dutch population. All respondents (N = 1259) completed the Groningen Defecation and Fecal Continence questionnaire. We...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3051-5
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND AND AIMS:Photodynamic therapy (PDT) is a new treatment modality for early esophageal neoplasia. With two absorption maxima in the visible light range (550 and 588 nm) hypericin is a very promising photosensitizer for PDT with incoherent light sources. We studied the effects of photosensitizing hypericin in b...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-002-0440-5
更新日期:2003-05-01 00:00:00
abstract:PURPOSE:No consensus exists regarding the use of preoperative bowel preparation for patients undergoing a low anterior resection (LAR). Several comparative studies show similar outcomes when a single time enema (STE) is compared with mechanical bowel preparation (MBP). It is hypothesized that STE is comparable with MBP...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03651-6
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:Several studies demonstrate an increased prevalence and concordance of inflammatory bowel disease among the relatives of patients. Other studies suggest that genetic influence is over-estimated. The aims of this study are to evaluate the phenotypic expression and the treatment requirements in familial inflammat...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-017-2791-y
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:Chemical sphincterotomy (CS) is routinely applied in order to avoid the irreversible anal incontinence associated with the surgical treatment of chronic anal fissure (CAF). However, CS has a lower cure rate than surgery. We developed a screening test (using anal manometry) to separate those patients that are un...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-010-0885-x
更新日期:2010-05-01 00:00:00
abstract:PURPOSE:Despite the recent growing interest of the scientific community, there is still no consensus on the actual applicability and effectiveness of sentinel lymph node (SL) procedure in colon cancers. This study aims to quantify feasibility, detection rate, negative predictive value, and accuracy of the SL identified...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03654-3
更新日期:2020-10-01 00:00:00
abstract::A combined manometric and radioisotope study is described which was designed to investigate the motility characteristics of induced defaecation in the colon, rectum and anal canal, in patients with severe constipation. Five women with severe idiopathic constipation, aged 30-45 years, were studied. A multiple channel w...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341220
更新日期:1992-12-01 00:00:00
abstract:PURPOSE:The present study was performed to get a better insight in the incidence of anastomotic leakage leading to reintervention when using the C-seal: a biodegradable sheath that protects the stapled colorectal anastomosis from leakage. METHODS:The C-seal is a thin walled tube-like sheath that forms a protective she...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1724-7
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:High level of microsatellite instability (MSI-H) in colorectal cancer (CRC) is caused by the inactivation of mismatch repair (MMR) genes; however, it is unknown for tumors with low level MSI (MSI-L). The protein complex involving MSH3 preferentially recognizes insertion/deletion loops (IDLs) of two to eight bas...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1408-0
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:The aim of this review is to clarify the involvement of the insulin-like growth factor (IGF) system in the development of colorectal malignancy. MATERIALS AND METHODS:Medline searches were used to identify key articles relating the IGF system with the development of colorectal cancer. RESULTS:The IGF system...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-005-0776-8
更新日期:2006-04-01 00:00:00
abstract:PURPOSE:The aim of the present study was to investigate the characteristics of patients who developed delayed anastomotic leakage (DAL) following sphincter-preserving surgery for rectal cancer. We evaluated the following factors: (1) the incidence of DAL, (2) the clinical features of patients who developed DAL, (3) the...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-010-0938-1
更新日期:2010-07-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the effect of a structured hands-on workshop on the detection rate of obstetric anal sphincter injuries. METHODS:All physicians attending the delivery ward in our institution participated in a structured obstetric anal sphincter injury hands-on workshop developed by Dr. ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2365-9
更新日期:2016-01-01 00:00:00
abstract::7,543 double-contrast barium enema studied for the presence of diverticula which were classified into right-sided, left-sided and bilateral types, and the relationship of the frequency (detection rate) and numbers of diverticula to age were examined for the earlier (1982-87) and later (1988-92) periods. Diverticular d...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00342463
更新日期:1996-01-01 00:00:00