000			03231cam a2200349 a 4500
003			EG-GiCUC
005			20250223032535.0
008			200621s2018 ua dh f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aPh.D
099			_aCai01.19.04.Ph.D.2018.Ah.E
100	0		_aAhmed Fouad Elkhatib
245	1	0	_aExtra-levator abdomino- perineal excision (ELAPE) versus standard abdomino perineal excision (SAPE) for low rectal cancer / _cAhmed Fouad Elkhatib ; Supervised Hassan A. Mebed , Samy Ramzy , Haitham Fekry Othman
246	1	5	_aالاستئصال الجذرى للاورام السرطانية السفلية بالمستقيم عن طريق البطن والعجان خارج العضلة الرافعة للشرج مقارنة بالطريقة التقليدية
260			_aCairo : _bAhmed Fouad Elkhatib , _c2018
300			_a245 P. : _bcharts , facsimiles ; _c25cm
502			_aThesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical)
520			_aBackground: In the literature, the Standard Abdomino-Perineal Excision (SAPE) is associated with high incidence of Intra-Operative Bowel Perforation (IOBP) and positive Circumferential Resection Margin (CRM) , both are major determinants of local recurrence. This led to introduction of a more radical surgery ,the Extralevator Abdomino-Perineal Excision (ELAPE), which improves the oncological outcomes of low rectal cancer surgery . The question whether this technique may confer an additional morbidity was investigated by many retrospective , single- and multi-institutional analysis which compared ELAPE and SAPE regarding their short term complications and more importantly their oncological outcome. Methods:This is a prospective randomized controlled trial that has been carried out in the National Cancer Institute (NCI), Cairo University , Egypt over the period of 42 months. Patients were randomized into 2 groups , 20 patients each. Group A: Patients treated with (ELAPE), and Group B: Patients treated with (SAPE). In both groups, each patient was followed for a period of 24 months .Data was extracted prospectively . The main endpoints of comparison between the two groups were the intra-operative factors including Estimated Blood Loss (EBL) , Operative time and IOBP, early post operative complications , Pathological factors and margin assessment and more importantly the oncological outcomes (CRM and Local Recurrence). Results:Patients{u2019} demographics and co-morbidities were comparable between the two groups . Operative time and EBL were comparable.There was significant statistical difference between the two groups regarding inadvertent IOBP (1 patient in Group A 25%3 vs 7 patients in Group B 235%3 with p-value = 0.044)
530			_aIssued also as CD
653		4	_aAbdomino
653		4	_aLow rectal cancer
653		4	_aPerineal excision (APE)
700	0		_aHaitham Fekry Othman , _eSupervisor
700	0		_aHassan A.Mebed , _eSupervisor
700	0		_aSamy Ramzy , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aShimaa _eCataloger
942			_2ddc _cTH
999			_c77015 _d77015