{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:10:37Z","timestamp":1783901437141,"version":"3.55.0"},"reference-count":23,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : To evaluate the effect of extralevator abdominoperineal excision of the rectum (ELAPE) on the circumferential resection margin (CRM) and overall survival in comparison to standard abdominoperineal excision of the rectum (APE) in patients with advanced rectal cancer.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Material and Methods<\/jats:bold>\n                    : This retrospective study encompasses patients with advanced rectal cancer operated on with two different methods: prone Jack-Knife position ELAPE and APE. In part of them, neoadjuvant chemoradiation was conducted. Postoperative patient, tumor, and outcome data were analyzed in terms of differences in CRM positivity and overall survival.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Of 67 patients treated with either APE (52) or ELAPE (15), 43 were male and 24 were female. Neoadjuvant treatment was conducted on 49 of the total patients. Complete pathological response (T0) was achieved in 3 patients. Positive CRM was reported in 7 patients (11.5 %), 3 in ELAPE and 4 in APE group (p = 0.348). The overall postoperative complication rate was 56.7%. Mean survival period was 42.2 months. Overall survival rate for both groups was 67.2 %. No statistical differences were seen between the ELAPE and APE procedure in terms of overall survival (p = 0.483).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Differences between the use of ELAPE and APE in terms of CRM positivity and overall survival were not statistically significant. Therefore, we conclude that ELAPE is not superior to standard APE in the treatment of advanced rectal cancer.\n                  <\/jats:p>","DOI":"10.2478\/prilozi-2022-0033","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T16:31:14Z","timestamp":1670344274000},"page":"21-27","source":"Crossref","is-referenced-by-count":0,"title":["Extralevator Abdominoperineal Excision (ELAPE) is Not Superior to Abdominoperineal Excision (APE) in the Era of Neoadjuvant Treatment in Rectal Cancer"],"prefix":"10.2478","volume":"43","author":[{"given":"Cemal","family":"Ulusoy","sequence":"first","affiliation":[{"name":"Department of General Surgery , Prof. Dr. Cemil Ta\u015f\u00e7\u0131o\u011flu \u015eehir Hastanesi , Istanbul , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Nikolovski","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, University Surgical Clinic \u201cSv. Naum Ohridski\u201d , University \u201cSv. Kiril i Metodij\u201d , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,12,4]]},"reference":[{"key":"2026071212092385198_j_prilozi-2022-0033_ref_001","doi-asserted-by":"crossref","unstructured":"1. M. A. Duggan, W. F. Anderson, S. Altekruse, L. Penberthy, and M. E. Sherman, \u201cThe Surveil-lance, Epidemiology, and End Results (SEER) Program and Pathology,\u201d Am. J. Surg. Pathol., vol. 40, no. 12, pp. e94\u2013e102, 2016, doi: 10.1097\/pas.0000000000000749.","DOI":"10.1097\/PAS.0000000000000749"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_002","doi-asserted-by":"crossref","unstructured":"2. J. Gandhi et al., \u201cPopulation-based study demonstrating an increase in colorectal cancer in young patients,\u201d Br. J. Surg., vol. 104, no. 8, pp. 1063\u20131068, 2017, doi: 10.1002\/bjs.10518.28378448","DOI":"10.1002\/bjs.10518"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_003","doi-asserted-by":"crossref","unstructured":"3. F. G. Campos, A. Habr-Gama, S. C. Nahas, and R. O. Perez, \u201cAbdominoperineal excision: Evolution of a centenary operation,\u201d Dis. Colon Rectum, vol. 55, no. 8, pp. 844\u2013853, 2012, doi: 10.1097\/DCR.0b013e31825ab0f7.22810469","DOI":"10.1097\/DCR.0b013e31825ab0f7"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_004","doi-asserted-by":"crossref","unstructured":"4. E. Rullier et al., \u201cIntersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer,\u201d Dis. Colon Rectum, vol. 42, no. 9, pp. 1168\u20131175, 1999, doi: 10.1007\/BF02238569.10496557","DOI":"10.1007\/BF02238569"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_005","doi-asserted-by":"crossref","unstructured":"5. R. J. Heald, R. K. Smedh, A. Kald, R. Sexton, and B. J. Moran, \u201cAbdominoperineal excision of the rectum--an endangered operation. Norman Nigro Lectureship.,\u201d Dis. Colon Rectum, vol. 40, no. 7, pp. 747\u201351, 1997, [Online]. Available: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9221846.10.1007\/BF020554259221846","DOI":"10.1007\/BF02055425"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_006","doi-asserted-by":"crossref","unstructured":"6. G. Jurell and J. Lagergren, \u201cExtended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer,\u201d pp. 232\u2013238, 2007, doi: 10.1002\/bjs.5489.17143848","DOI":"10.1002\/bjs.5489"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_007","doi-asserted-by":"crossref","unstructured":"7. J. G. Han, Z. J. Wang, G. H. Wei, Z. G. Gao, Y. Yang, and B. C. Zhao, \u201cRandomized clinical trial of conventional versus cylindrical abdominoperineal resection for locally advanced lower rectal cancer,\u201d Am. J. Surg., vol. 204, no. 3, pp. 274\u2013282, 2012, doi: 10.1016\/j.amjsurg.2012.05.001.22920402","DOI":"10.1016\/j.amjsurg.2012.05.001"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_008","doi-asserted-by":"crossref","unstructured":"8. Sayers, A E et al. \u201cPerineal hernia formation following extralevator abdominoperineal excision.\u201d Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland vol. 17,4 (2015): 351-5. doi: 10.1111\/codi.1284325413255","DOI":"10.1111\/codi.12843"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_009","doi-asserted-by":"crossref","unstructured":"9. A. Huang, H. Zhao, and T. Ling, \u201cOncological superiority of extralevator abdominoperineal resection over conventional abdominoperineal resection : a meta-analysis,\u201d pp. 321\u2013327, 2014, doi: 10.1007\/s00384-013-1794-6.24385025","DOI":"10.1007\/s00384-013-1794-6"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_010","doi-asserted-by":"crossref","unstructured":"10. D. Asplund, E. Haglind, and E. Angenete, \u201cOutcome of extralevator abdominoperineal excision compared with standard surgery : results from a single centre,\u201d pp. 1191\u20131196, 2012, doi: 10.1111\/j.1463-1318.2012.02930.x.22221401","DOI":"10.1111\/j.1463-1318.2012.02930.x"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_011","doi-asserted-by":"crossref","unstructured":"11. A. Carpelan, \u201cExtralevator versus standard abdominoperineal excision in locally advanced rectal cancer : a retrospective study with long-term follow-up,\u201d 2018.10.1007\/s00384-018-2977-y29445870","DOI":"10.1007\/s00384-018-2977-y"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_012","doi-asserted-by":"crossref","unstructured":"12. A. N. D. Study, \u201cExtraLevatory AbdominoPerineal Excision (ELAPE) Does Not Result in Reduced Rate of Tumor Perforation or Rate of Positive Circumferential Resection Margin,\u201d vol. 261, no. 5, pp. 933\u2013938, 2015, doi: 10.1097\/SLA.0000000000000910.25211268","DOI":"10.1097\/SLA.0000000000000910"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_013","doi-asserted-by":"crossref","unstructured":"13. A. Hussain, F. Mahmood, A. D. W. Torrance, H. Clarke, C. Howitt, and R. Dawson, \u201cOncological outcomes of abdominoperineal resection for the treatment of low rectal cancer : A retrospective review of a single UK tertiary centre experience,\u201d Ann. Med. Surg., vol. 34, no. June, pp. 28\u201333, 2018, doi: 10.1016\/j.amsu.2018.06.007.612580230191062","DOI":"10.1016\/j.amsu.2018.06.007"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_014","doi-asserted-by":"crossref","unstructured":"14. Tao, Yu et al. \u201cExtralevator abdominoperineal excision for advanced low rectal cancer: Where to go.\u201d World journal of gastroenterology vol. 26,22 (2020): 3012-3023. doi: 10.3748\/wjg.v26. i22.3012","DOI":"10.3748\/wjg.v26.i22.3012"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_015","doi-asserted-by":"crossref","unstructured":"15. X. Qi et al., \u201cExtralevator abdominoperineal excision versus abdominoperineal excision for low rectal cancer : a meta-analysis,\u201d vol. 0, no. 20, pp. 2446\u20132456, 2019, doi: 10.1097\/CM9.0000000000000485.683105931651517","DOI":"10.1097\/CM9.0000000000000485"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_016","doi-asserted-by":"crossref","unstructured":"16. A. Bradley, A. Hammad, and A. Mukherjee, \u201cExtralevator abdominoperineal excision (Elape): A retrospective cohort study,\u201d vol. 10, pp. 32\u201335, 2016, doi: 10.1016\/j.amsu.2016.07.016.497122927508080","DOI":"10.1016\/j.amsu.2016.07.016"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_017","unstructured":"17. L. Felipe, D. C. E. Aleman, and B. B. Vailati, \u201cExtralevator Abdominal Perineal Excision Versus Standard Abdominal Perineal Excision : Impact on Quality of the Resected Specimen and Postoperative Morbidity,\u201d no. 2, pp. 2\u20139, 2017, doi: 10.1007\/s00268-017-3963-1.28265736"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_018","doi-asserted-by":"crossref","unstructured":"18. G. Papp, K. Dede, and A. Bursics, \u201cShort-term advantages of ELAPE over APR,\u201d Acta Chir. Belg., vol. 121, no. 5, pp. 327\u2013332, 2021, doi: 10.1080\/00015458.2020.1778265.32496868","DOI":"10.1080\/00015458.2020.1778265"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_019","doi-asserted-by":"crossref","unstructured":"19. M. Nyandowe, A. Egedovo, and Y.-H. Ho, \u201cA comparative study of standard versus extralevator abdominoperineal resections,\u201d Int. Surg. J., vol. 4, no. 4, p. 1222, 2017, doi: 10.18203\/2349-2902.isj20170921.","DOI":"10.18203\/2349-2902.isj20170921"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_020","doi-asserted-by":"crossref","unstructured":"20. D. Kamali, A. Sharpe, A. Musbahi, and A. Reddy, \u201cOncological and quality of life outcomes following extralevator versus standard abdominoperineal excision for rectal cancer,\u201d pp. 402\u2013409, 2017, doi: 10.1308\/rcsann.2017.0038.544970528462642","DOI":"10.1308\/rcsann.2017.0038"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_021","doi-asserted-by":"crossref","unstructured":"21. Z. Shen et al., \u201cProspective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer,\u201d vol. 41, pp. 472\u2013477, 2015, doi: 10.1016\/j.ejso.2015.01.017.25659773","DOI":"10.1016\/j.ejso.2015.01.017"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_022","doi-asserted-by":"crossref","unstructured":"22. Colov, Emilie P et al. \u201cWound Complications and Perineal Pain After Extralevator Versus Standard Abdominoperineal Excision: A Nationwide Study.\u201d Diseases of the colon and rectum vol. 59,9 (2016): 813-21. doi: 10.1097\/DCR.000000000000063927505109","DOI":"10.1097\/DCR.0000000000000639"},{"key":"2026071212092385198_j_prilozi-2022-0033_ref_023","doi-asserted-by":"crossref","unstructured":"23. H. Zhang et al., \u201cLong-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer,\u201d BMC Surg., vol. 22, no. 1, pp. 1\u201310, 2022, doi: 10.1186\/s12893-022-01692-y.921912035733206","DOI":"10.1186\/s12893-022-01692-y"}],"container-title":["PRILOZI"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/prilozi-2022-0033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T23:55:26Z","timestamp":1783900526000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/prilozi-2022-0033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,12,4]]},"published-print":{"date-parts":[[2022,11,1]]}},"alternative-id":["10.2478\/prilozi-2022-0033"],"URL":"https:\/\/doi.org\/10.2478\/prilozi-2022-0033","relation":{},"ISSN":["1857-8985"],"issn-type":[{"value":"1857-8985","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,1]]}}}