Abdominoperineal resection in the prone position: early outcomes at a tertiary institution in the Western Cape, South Africa
Date
2020-09
Journal Title
Journal ISSN
Volume Title
Publisher
Medpharm
Abstract
BACKGROUND: Extra-levator abdominoperineal resection (ELAPE) performed in the prone jack-knife position is a new technique in the developing world. Literature on the outcomes of ELAPE in a developing country context is scarce. The objective was to assess early outcomes after ELAPE in the prone jack-knife position, and to compare outcomes of patients who underwent the abdominal part of the procedure performed laparoscopically with an open group, at a tertiary institution in Cape Town.
METHODS: Records of patients who underwent ELAPE for rectal adenocarcinoma from February 2011 to February 2017 at Tygerberg Hospital were retrospectively reviewed. Variables of interest included staging, rate of circumferential resection margin involvement (CRMI), intraoperative tumour perforation (IOP), perineal wound complications, early postoperative morbidity, length of intensive care unit (ICU) stay, duration of postoperative hospital stay and 30-day mortality rate.
RESULTS: 52 patients (median age: 59 years) were included in the analysis. CRMI was evident in 16% (8/49) of patients and IOP in 6% (3/52). Perineal wound complications occurred in 32% (16/50) of patients. Median length of ICU and postoperative hospital stay was 3 days and 7 days, respectively. Overall morbidity was 47% (24/51) and the 30-day mortality rate was 3% (2/52). A significant difference in length of hospital stay was evident between the open and laparoscopic groups (11.5 days vs 6 days
CONCLUSION: Prone abdominoperineal resection (APR), ELAPE, and laparoscopic ELAPE are acceptable and feasible procedures for patients with rectal cancer in the developing world, with outcomes being comparable to those determined in the developed world.
Description
CITATION: Stevenson, N., Lambrechts, A. V. V. & Forgan, T. 2020. Abdominoperineal resection in the prone position: early outcomes at a tertiary institution in the Western Cape, South Africa. South African Journal of Surgery, 58(3):154-159, doi:10.17159/2078-5151/2020/v58n3a3100
The original publication is available at: http://www.scielo.org.za
The original publication is available at: http://www.scielo.org.za
Keywords
Adenocarcinoma, Abdominoperineal section, Abdominoperineal resection, Colorectal cancer, Rectal cancer
Citation
Stevenson, N., Lambrechts, A. V. V. & Forgan, T. 2020. Abdominoperineal resection in the prone position: early outcomes at a tertiary institution in the Western Cape, South Africa. South African Journal of Surgery, 58(3):154-159, doi:10.17159/2078-5151/2020/v58n3a3100.