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Document Type

Original Article

Abstract

Background: The Anterior Perineal PlanE for Ultra-Low Anterior Resection (APPEAR) methodology was designed specifically for cases of extremely low rectal cancer. Its purpose is to aid with the removal of the most distant part of the rectum. This technique enables the maintenance of the sphincter and minimizes the necessity over abdominal resection (APR) & permanent stomas. Aim of the work : Our study evaluated the surgical, short-term oncological and functional outcomes of laparoscopic-assisted Anterior Perineal PlanE for the ultra-low Anterior Resection (APPEAR) procedure. Methods: A prospective study was conducted on a cohort of twenty patients diagnosed with low rectal cancer, who were administered neoadjuvant chemoradiation. They underwent preoperative evaluation and were reevaluated for a median of eighteen months post-surgery. Results: Among the 20 studied cases, two patients (10%) showed a complete response (CR) after neoadjuvant chemoradiation, and eight cases (40%) had positive lymph node metastasis. The distal resection margin was(35%) and 13 (65%) of patients, respectively. Systemic recurrence was seen in one patient (5%) after 14 months of surgery who had been subjected to systemic chemotherapy. The functional outcome has been evaluated in 19 cases (95%). The postoperative Wexner continence score was at a median of 6, and major LARS was noticed in only two patients (10.52%). Conclusion: The laparoscopic-assisted APPEAR technique can be considered an alternative approach To provide good anal function and maintain oncologic safety, sphincter-preserving operations for patients with low-rectal cancer are comparable to other surgical procedures.

Keywords

Rectal cancer; Low Anterior Resection; APPEAR technique; Sphincter-preserving operations

Subject Area

Onco-surgery

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