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A procedure for rectal or anal cancer is called an abdominoperineal resection. It is the surgical procedure used to remove the anus, rectum, and sigmoid colon to treat cancer that has spread extremely low in these regions. Once they are removed, a permanent colostomy allows the body to expel waste. An incision is made in the abdominal region to accomplish this. The surgery usually takes two to three hours to complete.
| Country | Cost | Local_currency |
|---|---|---|
| India | USD 5400 | 449010 |
| United States | USD 40050 | 40050 |
| United Kingdom | USD 6606 - 166118 | 5219 - 131233 |
| Turkey | USD 10000 | 301400 |
| Singapore | USD 39000 | 52260 |
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Abdominoperineal resection (APR) is a type of surgery in which the anus, rectum, and sigmoid colon are removed through small cuts in the belly. It is a surgical procedure done primarily to remove the cancer of the rectum. Typically, abdominoperineal resection (AP) is conducted as an elective procedure. This procedure is most often used to treat rectum cancer if it is located very low in the rectum or the anus, close to the sphincter muscles.
Nowadays, advanced surgical techniques and other treatment modalities have brought an increase in the rate of sphincter-sparing operations. However, APR surgery is still necessary in selected cases, especially if the patient has distal tumors or poor sphincter function. AP resection is a major operation. During perineal resection, the rectum, distal colon, and anal sphincter complex are completely removed using both anterior abdominal and perineal incisions. Once the anus and rectum are removed, a permanent colostomy is needed to complete the procedure.
Colostomy brings the colon to an opening at the surface of the skin, which allows the waste to pass out of the body. This new opening is called stoma and usually measures from one to one-and-a-half inches in diameter. A pouch, or a stoma appliance, is needed to be worn at all times. The stoma has no sphincter muscles, so there is no conscious control over the elimination of waste products from the body after the procedure.
APR is done to correct rectal cancer, particularly tumors that are very low in the rectum and near the anus. It's also used for anal cancer or severe inflammatory bowel disease. The intention is to excise the diseased rectum and anus to avoid the spread of cancer or disease.
If rectal bleeding persists, bowel habit changes for more than a few weeks, unexplained abdominal pain arises, there is unintended weight loss, or any signs and symptoms of bowel obstruction are noted by the doctor.
Preparation involves imaging (MRI, CT, or PET scans) to stage the disease, and bowel prep before surgery. You’ll meet with a stoma care nurse to learn about colostomy care. Medications like blood thinners may be stopped, and pre-op clearance is obtained.
It is a major surgical procedure done under general anesthetic conditions, where the anus, the rectum, and the sigmoid colon are removed through the abdominal and perineal incisions, and the surgeon forms a permanent colostomy, bringing the end of the colon through abdominal wall. Depending on the case, it applies to open surgery or minimally invasive methods such as laparoscopy or robotic surgery.
The surgery usually takes 3 to 5 hours; the complexity and requirements of other procedures may affect this time.
APR is efficacious in excising the cancer or diseased tissue and is curative for early cancers. It eliminates bleeding, obstruction, and pain symptoms, and increases survival if cancer is eliminated.
Generally, recovery follows hospital admission early for 5-10 days. They are observed for complications while provision is made for pain management to advance normal food intake. Early activities are encouraged to prevent clot formation. Post-discharge, colostomy care is essential, and patients get education from ostomy nurses. Complete recovery may take 6-8 weeks or longer. Follow-ups with oncology review, scans, and possibly chemotherapy or radiation will continue.
The prognosis of a patient undergoing APR is closely tied to the stage of cancer at the time of surgery. The procedure is carried out in fairly localised disease states, and clear margins warrant a high survival rate and effective cancer control.
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