Abdominoperineal Resection doctors in India

Why is Abdominoperineal Resection Performed?

Abdominoperineal resection, often shortened to APR, is a major surgical operation done to remove the rectum and anus when they are affected by disease such as cancer. In this procedure, the surgeon also removes part of the large intestine (sigmoid colon) so that all diseased parts are taken out. After these organs are removed, the surgeon creates a new opening on the front of the belly called a colostomy. Through this opening, waste leaves the body and collects into a special bag attached to the skin. This surgery is most often done when the disease is very low in the rectum or around the anus and cannot be removed without taking out these parts. It may also include the removal of nearby lymph nodes to stop the spread of the disease.

Abdominoperineal resection is a planned and serious procedure. Your surgeon and healthcare team will talk to you about how the operation is done, what you can expect before and after surgery, and how to look after yourself once you go home.

Why Is Abdominoperineal Resection Done?

This surgery is recommended by doctors in certain conditions, such as:

● Rectal cancer is located very low near the anus

● Anal cancer that has not responded to other treatments

● Tumors touching the anal sphincter muscles

● Some severe non-cancer diseases of the rectum or anus when other treatments don’t work

● Recurrent disease after previous treatments fails

● Other rare conditions causing poor function or pain in the lower bowel

Purpose & Benefits of Abdominoperineal Resection

● Removes diseased or cancerous tissue from the lower bowel

● Help prevent growth or spread of serious disease

● Reduces severe pain or symptoms caused by advanced tumors

● Can improve quality of life when less invasive options are not suitable

● Ensures complete removal of affected tissue in areas where sphincter-sparing surgery is not possible

Who May Need Abdominoperineal Resection?

● People diagnosed with low rectal cancer

● Patients with anal cancer are not responding to treatment

● Those with extensive tumours in the lower rectum or anus

● Individuals with non-healing diseases are not suited for other surgeries

● People with recurrent rectal or anal disease after treatment

Types of Abdominoperineal Resection

1. Open Abdominoperineal Resection

In this method, the surgeon makes a long cut on the abdomen and an incision around the perineal area (between the anus and scrotum or vagina) to remove the organs.

2. Laparoscopic Abdominoperineal Resection

Here, the surgeon makes several small cuts in the abdomen and uses a camera and special tools to remove the rectum and anus. This method often leads to smaller scars and quicker healing than open surgery.

3. Robotic Abdominoperineal Resection

Similar to the laparoscopic technique, but the surgeon uses a robotic machine to assist with precision surgery. This may help with better control and less tissue damage.

Procedure: Step-by-Step

1. Before Surgery – You will have tests like blood work, CT scans, and bowel preparation. The surgeon will explain risks and benefits.

2. Anesthesia – Surgery is done under general anesthesia (you will be asleep).

3. Abdominal Phase – The surgeon makes an incision in the abdomen and begins removing the rectum, part of the sigmoid colon, and any nearby lymph nodes.

4. Perineal Phase – An incision is made in the perineum to remove the anus and surrounding tissues.

5. Colostomy Creation – The healthy end of the remaining colon is brought out through the abdominal wall and stitched to the skin. This is called a stoma.

6. Closure – The surgeon closes the incisions and places dressings.

7. Recovery Room – You are moved to a recovery area to wake up from anesthesia.

The operation usually takes several hours. Your care team will monitor you closely after surgery.

Recovery & Aftercare

● You will stay in the hospital for several days.

● Pain medications and IV fluids will be given.

● You might have tubes to drain urine and fluids from the surgical area.

● You will learn how to care for your colostomy before you leave the hospital.

● Walking early helps breathing and healing.

● Full recovery may take 6–8 weeks or longer.

After discharge, follow-up appointments are important. You will be taught how to change the colostomy bag and care for your stoma at home.

Risks & Possible Complications

Although this is a common and safe surgery when done by experts, possible risks include:

● Infection at the wound or inside the abdomen

● Bleeding after surgery

● Blood clots in legs or lungs

● Problems with the colostomy (skin irritation, hernia)

● Slow bowel function or blockage

● Urinary or sexual function changes

● Pain or discomfort around the surgery site

● Anesthesia-related risks

Your surgeon will explain all risks before surgery.

Abdominoperineal Resection vs Other Treatments

Abdominoperineal Resection (APR)

● Removes rectum and anus completely

● Results in permanent colostomy

● Used when sphincter-preserving surgery is not possible

Low Anterior Resection (LAR)

● Removes only part of the rectum

● Keeps anal sphincter and normal bowel function

● No permanent colostomy

Local Excision or Radiation/Chemotherapy

● Less invasive

● Used for small or early tumors

● May not be suitable for advanced or low tumors

Your doctor will decide the best option based on your condition, tumour location and overall health.