Extralevator abdominoperineal excision for advanced low rectal cancer: Where to go

Table 1 Post-operative outcomes of extralevator abdominoperineal excision vs abdominoperineal excision

Refereces			Group	n	CRM+(%)	IOP(%)	Local recurr-ence(%)	Post-operative complications				QoL scores
Authors	Year	Type						Perineal wound compli-cations (%)	Urinary retention(%)	Sexual dysfunc-tion (%)	Chronic perineal pain (%)
West et al[11]	2010	Retro case-control	ELAPE/APR	176/124	20.3/49.6, P < 0.001	8.2/28.3, P < 0.001	-	38/20, P = 0.019	46/17, P = 0.579	46/33, P = 0.192	-	-
Han et al[13]	2012	RCT	ELAPE/APR	35/32	5.7/28.1	5.7/15.6, P = 0.246	2.8/18.8, P = 0.048	37.1/31.3 P = 0.612	40/28.1, P = 0.307	74/60, P = 0.306	51.4/6.3, P < 0.001	-
Asplund et al[17]	2012	Retro case-control	ELAPE/APR	79/79	17/20, P = 0.647	13/10, P > 0.05	9/9, P = 1	46/28, P < 0.05	-	-	-	-
Vaughan-Shaw et al[58]	2012	Pro case-control	ELAPE/LAPR/OAPR	16/10/10	0/1/2, P > 0.05	0/0/1, P > 0.05	-	2/5/2, P = 0.21	3/2/2, P = 0.99	-	-	85.4/77.5/78.5, P > 0.05
Ortiz et al[66]	2014	Retro case-control	ELAPE/APR	457/457	13.6/13.1, P > 0.846	7.7/7,9, P > 0.902	5.6/2.7, P > 0.664	21.9/26, P > 0.141	-	-	-	-
Shen et al[55]	2015	Pro case-control	ELAPE/APR	36/33	4/12, P = 0.297	5.6/21.2, P = 0.028	0/15.2, P < 034	8.3/27.3, P = 0.039	11.1/3, P = 0.359	11.8/36.4, P = 0.127	-	P > 0.05
Wang et al[57]	2015	Retro case-control	ELAPE/APR	23/25	4.3/28, P = 0.028	0/20, P = 0.023	8.7/32, P = 0.047	39.1/24, P = 0.259	26.1/12, P = 0.212	60/37.5, P = 0.210	47.8/8, P = 0.002	P > 0.05
Klein et al[19]	2015	Retro case-control	ELAPE/APR	301/253	16/7, P = 0.001	2/3, P = 0.373	-	14/10, P = 0.143	-	-	-	-
Prytz et al[67]	2016	Pro case-control	ELAPE/APR	518/209	41.5/38.4, P < 0.0001	P < 0.001	P < 0.001	P < 0.001	-	-	-	-
Stelzner et al[16]	2016	Pro case-control	ELAPE/APR	36/36	2.9/2.8, P = 1	0/16.7, P = 0.025	5.9/18.2, P = 0.153	16.7/36.1, P = 0.061	-	-	-	-
Kamali et al[54]	2017	Pro case-control	ELAPE/APR	27/21	7.4/9.5, P = 0.50	-	3.7/4.7, P = 1	37/24, P > 0.05	-	-	-	77.3/65.3, P = 0.27
Habr-Gama et al[12]	2017	Retro case-control	ELAPE/APR	22/50	13.6/16.6, P = 0.70	0/8, P = 0.30	4.5/28.6, P = 0.01	22.7/46, P = 0.007	-	-	-	-
Carpelan et al[18]	2018	Retro case-control	ELAPE/APR	42/27	24/41, P = 0.136	10/22, P = 0.134	7/19, P = 0.247	45/30, P = 195	-	-	5/4, P > 0.05	-
Shen et al[15]	2019	Retro case-control	ELAPE/APR	106/88	4.2/6.5, P > 0.05	-	3.8/11.25, P = 0.027	17.0/14.8, P = 0.699	7.5/3.4, P = 0.353	-	-	-

ELAPE: Extralevator abdominoperineal excision; APR: Abdominoperineal excision; RCT: RANDOMISED Controlled Trial; CRM+: Positive circumferential resection margins; IOP: Intraoperative perforation; QoL: Quality of life; LAPR: Laparoscopic abdominoperineal excision; OAPR: Open abdominoperineal excision. Pro: Prospective. Retro: Retrospective.