Extralevator abdominoperineal excision was introduced as an alternative to conventional abdominoperineal excision for low rectal cancers. The perineal dissection is more extensive with extralevator abdominoperineal excision and leaves a greater defect.
The aim of this study was to evaluate, on a national basis, the risk of perineal wound complications, pain, and hernia after conventional and extralevator abdominoperineal excision performed for low rectal cancer.
This was a retrospective study collecting data from the Danish Colorectal Cancer Group database and from electronic medical files of patients.
The study was conducted at Danish surgical departments.
A total of 445 patients operated between 2009 and 2012 with extralevator or conventional abdominoperineal excision were included.
The main end points of this study were perineal wound complications and pain lasting for >30 days after the operation.
The 2 groups were demographically similar except for a higher ASA score in the conventional group. In the extralevator group, neoadjuvant chemoradiation was more frequent (71% vs 41%; p