{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:54:25Z","timestamp":1792670065987,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T00:00:00Z","timestamp":1499299200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aims of this study were to assess the feasibility of performing an extralevator abdominoperineal excision (<jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content>) after neoadjuvant chemoradiation (<jats:styled-content style=\"fixed-case\">NCRT<\/jats:styled-content>), to compare the rates of circumferential resection margin (<jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content>) involvement and intra\u2010operative perforation (<jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content>) of the specimen, and to assess the amount of tissue removed around the muscularis propria (<jats:styled-content style=\"fixed-case\">MP<\/jats:styled-content>)\/internal sphincter (<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>) of the lower rectum in patients with low rectal cancer undergoing <jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content> compared with conventional abdominoperineal excision (<jats:styled-content style=\"fixed-case\">CAPE<\/jats:styled-content>) after <jats:styled-content style=\"fixed-case\">NCRT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was an open\u2010label, parallel\u2010arm pilot randomized trial conducted in India. Twenty patients were randomized to one of the study arms. The surgical specimens were fixed, serially cross\u2010sectioned and photographed. Using specialized morphometry software, the amount of tissue resected with each operation was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a nonsignificant trend towards more <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content>s (30% <jats:italic>vs<\/jats:italic> 0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.06) and a higher <jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content> involvement rate (40% <jats:italic>vs<\/jats:italic> 20%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.32) in the <jats:styled-content style=\"fixed-case\">CAPE<\/jats:styled-content> arm. <jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content> removed a significantly greater amount of tissue around the <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">MP<\/jats:styled-content> when compared with <jats:styled-content style=\"fixed-case\">CAPE<\/jats:styled-content> (mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>: 1911.39\u00a0\u00b1\u00a0382\u00a0mm<jats:sup>2<\/jats:sup> <jats:italic>vs<\/jats:italic> 1132.03\u00a0\u00b1\u00a0371\u00a0mm<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The mean distance from the <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">MP<\/jats:styled-content> to the <jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content> was significantly greater in the <jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content> arm both in the posterior (mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>: 28.28\u00a0\u00b1\u00a03\u00a0mm <jats:italic>vs<\/jats:italic> 9.63\u00a0\u00b1\u00a03\u00a0mm, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and lateral (mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>: 13.69\u00a0\u00b1\u00a03\u00a0mm <jats:italic>vs<\/jats:italic> 9.72\u00a0\u00b1\u00a03\u00a0mm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009) parts of the rectum but not in the anterior part (mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>: 6.74\u00a0\u00b1\u00a02\u00a0mm <jats:italic>vs<\/jats:italic> 6.10\u00a0\u00b1\u00a04\u00a0mm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.64). The short\u2010term morbidity was not significantly different between the two procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">ELAPE<\/jats:styled-content> removed more tissue in the lower rectum and resulted in a lower rate of <jats:styled-content style=\"fixed-case\">IOP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CRM<\/jats:styled-content> involvement when compared with <jats:styled-content style=\"fixed-case\">CAPE<\/jats:styled-content>, even after <jats:styled-content style=\"fixed-case\">NCRT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13726","type":"journal-article","created":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T06:56:49Z","timestamp":1494831409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A pilot randomized study comparing extralevator with conventional abdominoperineal excision for low rectal cancer after neoadjuvant chemoradiation"],"prefix":"10.1111","volume":"19","author":[{"given":"R. A.","family":"Seshadri","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Cancer Institute (WIA) Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. P.","family":"West","sequence":"additional","affiliation":[{"name":"Pathology and Tumour Biology Leeds Institute of Cancer and Pathology University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sundersingh","sequence":"additional","affiliation":[{"name":"Department of Oncopathology Cancer Institute (WIA) Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2013.09.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2006.12.020"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000167926.60908.15"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.11.039"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-003-0012-y"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.9231"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4390"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5489"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.5961"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6916"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.05.001"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds236"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2003.12.006"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200111000-00008"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6602947"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01645318"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003840050072"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-013-1793-7"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4368-8"},{"key":"e_1_2_10_22_1","first-page":"14855","article-title":"Outcome of extralevator abdominoperineal excision over conventional abdominoperineal excision for low rectal tumor: a meta\u2010analysis","volume":"8","author":"Yang Y","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12921"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-3378-7"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1235-3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-014-1932-9"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-015-2328-1"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000639"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.13726","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.13726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T08:16:25Z","timestamp":1696320985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.13726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1111\/codi.13726"],"URL":"https:\/\/doi.org\/10.1111\/codi.13726","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2017-01-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-04-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}