Abdominal perineal resection

Abdominal perineal resection (APR) is a surgery performed to treat cancers located in the lower section of the rectum and anus. This procedure involves the removal of the anus, rectum, and part of the sigmoid colon, along with associated lymph nodes. The end of the remaining sigmoid colon is then brought out through an opening (stoma) made in the abdomen, creating a colostomy.

Procedure

The procedure is performed under general anesthesia and involves two main steps. The first step is performed through an abdominal incision, where the sigmoid colon and rectum are mobilized and the involved lymph nodes are removed. The second step is performed perineally, where the anus and rectum are removed. The sigmoid colon is then brought out through the abdominal wall to form a permanent colostomy.

Indications

Abdominal perineal resection is typically indicated for cancers of the lower rectum and anus that cannot be removed by transanal excision due to their size or location. It may also be used in cases where sphincter-preserving surgery is not possible or desired.

Complications

As with any major surgery, abdominal perineal resection carries potential risks and complications. These may include infection, bleeding, anastomotic leak, and complications related to the colostomy, such as stoma complications or parastomal hernia.

Postoperative Care

Following surgery, patients will require care and education on managing their colostomy. This includes learning how to change the colostomy bag, recognizing signs of complications, and adjusting to life with a colostomy.

See Also

• Colostomy
• Rectal cancer
• Anus
• Sigmoid colon
• General anesthesia