The circumferential resection margin positivity rate is about 5% or less for low anterior resections with TME, whereas it is between 10% and 25% for abdominoperineal excision
of the rectum.
Extralevator abdominoperineal excision (ELAPE) has been shown to lead to fewer episodes of bowel perforation and fewer positive circumferential resection margins (CRMs) when compared with conventional abdominoperineal excision (APE) because it achieves a specimen of a more cylindrical shape.,,,,, Recently, the occurrence and implications of perineal symptoms following ELAPE have been gradually realized; they occur partly because of the wider excision and the presence of more tissue around low rectal tumors when compared with conventional APE.
West NP, Anderin C, Smith KJ, Holm T, Quirke P; European Extralevator Abdominoperineal Excision Study Group, et al.
(APE) was the standard of care for anal canal squamous cell carcinoma before the introduction of radiotherapy with induction chemotherapy.
Branagan et al., "Comparative quality of life in patients following abdominoperineal excision
and low anterior resection for low rectal cancer," Diseases of the Colon & Rectum, vol.
Burt et al., "The use of a negative pressure wound management system in perineal wound closure after extralevator abdominoperineal excision
(ELAPE) for low rectal cancer," Techniques in Coloproctology, vol.
Forman, "Unacceptable variation in abdominoperineal excision
rates for rectal cancer: time to intervene?" Gut, vol.
Abdominoperineal excision (APE) is a surgical treatment used to treat cancer of the lower third of the rectum or anus where sphincter-preserving surgery (anterior resection (AR) with anastomosis) is not possible.
A systematic review of cancer related patient outcomes after anterior resection and abdominoperineal excision for rectal cancer in the total mesorectal excision era.
of the rectum-An endangered operation.
Moran, "Abdominoperineal excision
of the rectum--an endangered operation.
Background: When compared with conventional abdominoperineal resection (APR), extralevator abdominoperineal excision
(ELAPE) has been demonstrated to reduce the risk of local recurrence for the treatment of locally advanced low rectal cancer.