Abdominoperineal resection
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor In Chief: Cafer Zorkun, M.D., Ph.D. [2]
Abdominoperineal resection of the rectum (AP resection) is a surgical operation to treat usually malignant disease of the rectum or anal canal, and it involves removal of the anus, the rectum, and part of the sigmoid colon along with their draining lymph nodes, through incisions made in the abdomen and perineum. The end of the remaining sigmoid colon is brought out permanently as an opening on the surface of the abdomen, called a colostomy. Fecal matter from the colostomy is collected in a disposable bag that covers the colostomy.
This complex operation is one of the less common performed by General Surgeons, although they are specifically trained to perform this operation. As a consequence of the complexity of this operation and its difficult execution, it has been shown that this operation is performed with fewer complications in "Centers of Excellence," such as academic hospitals where this operation is performed by Colon and Rectal surgical subspecialists in some iteration weekly, if not daily.
The principal indication for AP resection is a rectal carcinoma situated in the lower third of the rectum, within about 5cm of the anal verge. Other indications include recurrent or residual anal carcinoma (squamous cell carcinoma) following initial, usually definitive combination chemoradiotherapy. AP resection includes regional lymph node removal (lymphadenectomy).
Stomata are openings in the body, either natural, such as the mouth, or artificial, such as colostomy. Any hollow organ can be manipulated into a stoma as necessary. This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, and kidney pelves.