Abdominoperineal resection From Wikipedia, the free encyclopedia Jump to: navigation, search
Abdominoperineal resection.
An abdomino abdominoperineal inoperineal resection, resection formally known as abdominoperineal resection of the rectum and abdominoperineal excision is a surgery abdominoperineal excision of the rectum or simply abdominoperineal excision, for rectal cancer. It is frequently abbreviated as AP resection and APR. APR
[edit] edit] Indication and description The principal indication for AP resection is a rectal carcinoma situated in the lower third of the rectum. Other indications include recurrent or residual anal carcinoma (squamous cell carcinoma) following initial, usually definitive combination chemoradiotherapy. APRs involves removal of the anus, the rectum and part of the sigmoid colon along with the associated (regional) lymph nodes, through incisions made in the abdomen and perineum. The end of the remaining sigmoid colon is brought out permanently as an opening, called a colostomy, on the surface of the abdomen.
[edit] edit] Centralisation of rectal surgery surgery This operation is one of the less commonly performed by general surgeons, although they are specifically trained to perform this operation. As low case volumes in rectal surgery have been found to be associated with higher complication rates,[1][2] it is often centralised in larger centres,[3] where case volumes are higher.
[edit] edit] Relation to anterior resection An APR, generally, results in a worse quality of life than the less invasive lower anterior resection.[4][5] Thus, LARs are generally the preferred treatment for rectal cancer insofar as this is surgically feasible.
APRs are the preferred operation for cancer in the distal one-third of the rectum.[6]
[edit] edit] See also Stoma (medicine)
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Health science - Surgery - General surgery neck esophagus - stomach abdomen (non-GI) liver - pancreas gallbladder - biliary tree
Resection (Thyroid cancer, Lymphoma) Resection (Esophageal cancer, Stomach cancer), Bariatric surgery (Morbid obesity), Repair (Trauma) Debulking surgery, Hernia repair Liver transplant (Hepatitis, Cirrhosis, PBC, PSC), Resection (HCC, Metastatic disease of the liver), Resection (Whipple procedure (Pancreatic cancer)), Cholecystectomy (Cholecystitis)
small intestine
Resection (due to bowel infarction and/or small bowel obstruction Intussusception, Volvulus, Crohn's disease, Meckel's diverticulum, Meconium ileus (due to Cystic fibrosis), Cancer of the small bowel), diversion - ileostomy, loop ileostomy (small bowel obstruction, perforation/sepsis)
colon
Appendectomy (Appendicitis), Resection (Lower anterior resection, Abdominoperineal resection, Hemicolectomy, Total colectomy, Local excision) due to obstruction and/or perforation/threatened perforation and/or malignancy (Toxic megacolon (due to IBD), Colon cancer, Rectal cancer, Hirschsprung's disease, Trauma, Intussusception, Volvulus, Inguinal hernia, Adhesions (due to previous surgery)), diversion - colostomy, Hartmann's procedure (large bowel obstruction, GI viscus perforation/sepsis, diverticulitis)
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