Abdominoperineal Resection

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What is Abdominoperineal Resection?

Abdominoperineal Resection (APR) is a surgical procedure primarily used to treat cancers in the lower rectum or anus. It involves the removal of the anus, rectum, and sigmoid colon, resulting in a permanent colostomy. This procedure is often recommended when other treatment options are not viable due to the location or severity of the cancer.

When is Abdominoperineal Resection Recommended?

APR is commonly performed for:

Rectal Cancer: Especially in the lower third of the rectum.
Anal Cancer: When tumors cannot be removed without affecting nearby structures.
Crohn’s Disease or Ulcerative Colitis: In severe cases where other treatments fail.

The APR Procedure: Step-by-Step

Preparation: Patients undergo bowel preparation and anesthesia.
Surgical Removal: The surgeon removes the affected areas, including the rectum and anus.
Colostomy Creation: A stoma is created to divert waste.

Recovery After Abdominoperineal Resection

Hospital Stay: Typically 7–10 days.
Pain Management: Medications to control discomfort.
Colostomy Care: Education on stoma care and managing the colostomy bag.

Risks and Complications

Infection or bleeding
Delayed wound healing
Emotional and psychological challenges related to living with a colostomy

Causes

Rectal Cancer: The most common reason for this surgery is the presence of cancer in the rectum that cannot be treated effectively with other methods.
Advanced Tumors: Tumors that are large or have spread to nearby tissues may require this extensive surgical approach.
Inability to Preserve Anal Function: In cases where the tumor is too low in the rectum, preserving the anal sphincter may not be possible.

Symptoms

Blood in the stool.
Changes in bowel habits, such as diarrhea or constipation.
Abdominal pain or discomfort.
Unexplained weight loss.
A palpable mass in the abdomen or rectal area.

Diagnosis

Physical Examination: A healthcare provider may perform a rectal examination to check for abnormalities.
Imaging Tests: CT scans or MRI can help visualize the extent of the tumor and surrounding tissues.
Colonoscopy: A procedure to examine the colon and rectum, allowing for biopsy if needed to confirm cancer.

Treatment

Surgery: The abdominoperineal resection itself, which removes the rectum and anus and creates a permanent colostomy (an opening in the abdominal wall for waste elimination).
Adjuvant Therapy: Following surgery, patients may receive chemotherapy or radiation therapy to reduce the risk of cancer recurrence.
Rehabilitation: Support and education on living with a colostomy, including dietary adjustments and potential lifestyle changes.

Benefits

Effective removal of cancerous tumors.
Reduced chance of cancer recurrence.
Improved survival rates for some patients.
Relief from symptoms like pain or bleeding.
Better overall quality of life after treatment.

Needs of Lifestyle Changes

Eating a healthy diet with fruits and vegetables.
Engaging in regular light exercise.
Staying hydrated.
Caring for the surgical wound as advised.
Attending routine check-ups.
Seeking emotional support if needed.

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