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Abdominoperineal resection removes entire rectum, anus, and sphincter complex for very low rectal cancers. Creates permanent colostomy. Only option when tumor proximity to anus precludes sphincter-saving surgery.
Two-team approach: abdominal team performs colostomy and rectal mobilization. Perineal team removes anus, sphincter, and surrounding tissue. Primary closure of perineal wound.
Hospital stay 5-7 days. Perineal wound healing 6-8 weeks. Return to activities 6-8 weeks. Colostomy adjustment 3-6 months. Most patients adapt well to colostomy and resume normal activities.
Local recurrence <5% with complete resection. Survival rates similar to LAR when appropriate patient selected. Excellent oncological control. Colostomy becomes second nature for most patients.
Accurate estimate can be obtained from hospital while visiting the doctor.
Abdominoperineal resection (APR) is an operation to remove the rectum, the anal canal and the surrounding tissues. It is mainly used for rectal cancers that are very close to or involve the anal sphincter muscles, where it is not possible to remove the cancer safely and still keep the sphincter. Because the anus is removed, a permanent end colostomy is created.
Many low rectal cancers can now be treated with sphincter-saving surgery, so APR is considered only when it gives the safest chance of removing the cancer completely.
The operation has an abdominal part and a perineal (bottom) part. The rectum is freed through the abdomen, often by laparoscopic or robotic surgery, and the lower part is removed through an incision around the anus, which is then closed. The end of the colon is brought out through the abdominal wall as a colostomy. Lymph nodes around the rectum are removed and examined.
Many patients receive chemotherapy and/or radiotherapy before surgery to shrink the tumour and reduce the chance of the cancer returning. Further chemotherapy may be advised after surgery depending on the final report.
Risks include wound infection or delayed healing of the perineal wound, bleeding, urinary or sexual problems due to nerves near the rectum, and stoma-related problems such as a hernia.
Yes. After APR the colostomy is permanent because the anus is removed.
Not always. Depending on the tumour's position and response to treatment, sphincter-saving operations such as low anterior resection or intersphincteric resection may be possible.
In suitable patients, the abdominal part can be done by laparoscopic or robotic surgery, which may reduce pain and speed recovery.
Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.