Abdominoperineal Resection

Procedure

What is Abdominoperineal resection procedure?

Abdominoperineal resection procedure is a surgery used to treat cancer in the anus, rectum and sigmoid colon. During the procedure all the three are removed.

What are the symptoms of anus,

rectum and sigmoid colon cancer?

Following are the symptoms of anus, rectum and sigmoid colon cancer:

  • Dark color or bright red stools
  • Sudden and unexplained weight loss
  • Abdominal pain
  • Fatigue and weakness
  • Problem in the bowel movements
  • Diarrhea
  • Lump near the anus
  • Bleeding from the anus and rectum 
  • Pain in the anus
  • Problems in the bowel movements and change in the bowel habits
  • Fatigue
  • Rectal bleeding
  • Muscle cramps and pain
  • Gas
  • Diarrhea
  • Abdominal pain

How to prepare for the

surgery?

The doctor will advise a full physical examination before the surgery, to check for any other complication that needs to be addressed before surgery.

The doctor will inform the patient about the requirement of having a ‘stoma’ after the surgery.

A stoma is an opening in the belly wall that is made during the surgery by the doctor in order for the waste to leave the body, which doesn’t happen if there is no bowel movement through the rectum.

The waste from the stoma collects in the colostomy bag.

How is the procedure

carried out?

The surgery is carried out under the influence of general anesthesia. The patient will be put on IV drip so that there is a constant nutrient supply to his/her body.

Preparing for sigmoid colon and rectum removal:

 The abdominoperineal resection procedure is a complex operation and involves a lot of procedures that lead up to the actual surgery.

The blood vessels that supply to the affected region are freed from their attachments and surrounding structures. Then the sigmoid colon is separated from the large intestine.

Preparing for anus removal:

 After the sigmoid colon and rectum removal the surgeon then prepares for anus removal.

The perineal region is operated upon and the anus is removed.

In a laparoscopic approach general anesthesia will be administered to the patient and as a result he/she will be asleep during the surgery.

Once the patient is asleep the process begins by making incisions near the belly button and a small device is inserted which is called a port; it creates an opening that will be filled with gas (carbon dioxide) in the abdomen region.

Through these incisions a Laparoscope (a Laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the affected body part and through the other incisions that are made the damaged/affected part is removed. In this case the anus, sigmoid colon and rectum are removed.

How long does it take to recover and

what should be the care taken?

The stay at the hospital will last for a week to fifteen days and it may vary depending on the individual’s condition.

It is a major procedure and after the surgery, the patient will require constant oxygen supply. So the patient will be put under a ventilator.

Supply of essential nutrients will be continued through IV.

A catheter will be attached to the patient, in order to drain urine.

The patient will be put on painkillers by the doctors to overcome pain from surgical wounds. 

The patient will be prescribed ibuprofen to reduce pain and docusate to prevent constipation and help in smooth bowel movements.

The patient will also be asked to follow a specific diet which will require him/her to consume soft or liquefied foods, including mashed potatoes, smoothies, and soups.

It is better to contact the doctor if complications like blood clots, excessive pain in the abdomen, high fever, pus and blood discharge from the incisions occur.

The patient will be taught enterostomal therapy that will be helpful in caring for stoma.

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