An overview of extralevator abdominoperineal excision (ELAPE) for low rectal cancer. DİSTALDEKİ REKTAL KANSERLER İÇİN EKSTRALEVATOR ABDOMİNOPERİNEAL REZEKSİYON (ELAPE) TEDAVİSİ.

APE for low rectal cancer is associated with high rate of tumor perforation, CRM involvement. It is well established that bowel perforation and CRM involvement are strong predictors of local recurrence and survival in rectal cancer. Extralevator Abdominoperineal Excision [ELAPE] avoids dissecting the mesorectum off the levator ani muscle and divides the levators laterally at their point of insertion to the pelvic bony-ligamentous ring. ELAPE is associated with slightly higher local complication in compare to conventional APE. A recent multicentre analysis has reported the use of ELAPE in reducing the CRM involvement and perforation rate. OZET Abdominoperineal rezeksiyonlar (APR) sirasinda tumor perforasyonu riski ve colorektal mezonun (KRM) kirlenmesi ihtimali yuksektir.  Tumorun perforasyonu ve KRM tutulumu ameliyat sonrasi erken nuksun onemli bir habercisidir. Ekstralevator APR yapilmasi ile KRM’nun diseksiyonu yapilmayacagi icin, klasik yaklasimda gorulene gore daha az lokal nuks oldugu bilinmektedir. Konuyla ilgili olarak son zamanlarda ELAPE’nin nuksu azalttigina dair yayinlar artmaktadir. Burada, konu literatur verileri isiginda tartisilmistir.