Endoscopically assisted extralevator abdominoperineal excision

• DOI: 10.1111/codi.13144
• Publication Date: 2015-10-10T13:57:45Z
• Authors: N. C. Buchs; R. Kraus; N. J. Mortensen; C. Cunningham; B. George; O. Jones; R. Guy; S. Ashraf; I. Lindsey; R. Hompes
• Keywords: Lithotomy position; Prone position; Perforation; Abdominoperineal resection

Abstract Aim Extralevator abdominoperineal excision (ELAPE) has been advocated to optimize clearance of lower third rectal cancers with an involved or threatened circumferential resection margin. ELAPE could reduce positive margins and specimen perforation compared standard excision. However, there can be difficulties ELAPE, particularly in identifying the anterior plane male patients. Usually, dissection is performed prone position, which hazardous, obese patients whom wound problems are commonly encountered. We describe endoscopically assisted approach for lithotomy position. Method Three a tumour located at anorectal junction underwent position after preoperative radiotherapy. Results All procedures were successfully operation times 180, 390 420 mins. There no instances intra‐operative other complications. One patient developed postoperative intestinal obstruction resolved on conservative management. Histopathological examination demonstrated clear intact mesorectal planes each patient. Conclusion report good outcome three ELAPE. This allows operated giving excellent views dissection.