Comparison of Extralevator Abdominoperineal Excision (ELAPE)and Abdominal - Perineal Resection (APR)

To compare the difference between the extralevator abdominoperineal excision (ELAPE) and abdominal perineal resection (APR) in circum ferencial resection margin (CRM) positive rate, intraoperative perforation (IOP) the incidence of postoperative wound infection, incision infection reoperation rate, surgical indications, operation time, hemorrhage volume, the recurrence rate, postoperative quality of life (perineal pain, urinary and reproductive function). By searching the literature about ELAPE and APR , reviewed their clinical value. ELAPE has greater advantages in reducing the CRM ,IOP and the recurrence rate in patients with low colorectal cancer , lowert he hemorrhage volume than the APR, but surgical area larger defects appear perineal pain, increase the incidence of urinary and reproductive dysfunction, and longer operative time with respect to the APR. APR is the first choice for low colorectal cancer patient with cT1 ~ 2 or ycT0 ~ 2 period ; after neoadjuvant chemoradiotherapyand tumor stage ycT3 ~ 4 stage patients ELAPE is more appropriate, ELAPE in postoperative complications, postoperative quality of life aspect is also worth to wait.