Abstract
In the last decade cylindrical or extralevator abdominoperineal excision (ELAPE) has showed a lower rate of bowel perforations and fewer positive circunferential resection margen compared with conventional excision. Unfortunately, there is conflicting evidence from meta-analyses and cooperative trials in terms of postoperative morbidity, local recurrence and long-term survival. According to the current evidence, selective ELAPE should be the best approach en some of the cases of low rectal cancer after preoperative radiotherapy, but conventional APE is a valid option in other cases of low tumors. Clinical evaluation and magnetic resonance of the pelvis has an important role in the decision-making.
