Abdominoperineal resection

Abdominoperineal resection

An abdominoperineal resection (APR) is a surgical procedure used primarily to treat rectal cancer and anal cancer. This operation involves the removal of the anus, rectum, and sigmoid colon, resulting in a permanent colostomy. The procedure is typically performed when the cancer is located very low in the rectum or in the anus, making it difficult to preserve the anal sphincter.

Indications

Abdominoperineal resection is indicated for:

• Low-lying rectal cancer
• Anal cancer
• Recurrent or persistent anal fistulas
• Severe inflammatory bowel disease affecting the rectum and anus

Procedure

The APR procedure is performed under general anesthesia and involves two main surgical approaches:

• **Abdominal approach**: The surgeon makes an incision in the abdomen to access and remove the sigmoid colon and rectum.
• **Perineal approach**: An incision is made around the anus to remove the anus and surrounding tissues.

After the removal of the affected areas, the end of the remaining colon is brought out through an opening in the abdominal wall to create a colostomy. This allows for the elimination of waste from the body.

Recovery and Complications

Recovery from an abdominoperineal resection can take several weeks. Patients may experience pain, fatigue, and changes in bowel habits. Common complications include:

• Infection
• Bleeding
• Hernia
• Sexual dysfunction
• Urinary dysfunction

Postoperative Care

Postoperative care involves managing the colostomy, monitoring for complications, and ensuring proper wound healing. Patients may need to work with a stoma nurse to learn how to care for their colostomy.

Related Pages

• Rectal cancer
• Anal cancer
• Colostomy
• Inflammatory bowel disease
• Surgical oncology