World Library  
Flag as Inappropriate
Email this Article

Abdominoperineal resection

Article Id: WHEBN0001300804
Reproduction Date:

Title: Abdominoperineal resection  
Author: World Heritage Encyclopedia
Language: English
Subject: Lower anterior resection, Digestive system surgery, General surgery, Liver transplantation, Hernia repair
Collection: Digestive System Surgery, General Surgery
Publisher: World Heritage Encyclopedia
Publication
Date:
 

Abdominoperineal resection

An abdominoperineal resection, formally known as abdominoperineal resection of the rectum and abdominoperineal excision of the rectum or simply abdominoperineal excision, or the Miles operation is a surgery for rectal cancer or anal cancer. It is frequently abbreviated as AP resection, APR and APER.

Contents

  • Indication and description 1
  • Centralisation of rectal surgery 2
  • Laparoscopic approach 3
  • Relation to low anterior resection (LAR) 4
  • Eponym 5
  • See also 6
  • References 7
  • External links 8

Indication and description

Abdominoperineal resection.

The principal indication for AP resection is a rectal carcinoma situated in the distal (lower) one-third of the rectum.[1] Other indications include recurrent or residual anal carcinoma (squamous cell carcinoma) following initial, usually definitive combination chemoradiotherapy.

APRs involves removal of the anus, the rectum and part of the sigmoid colon along with the associated (regional) lymph nodes, through incisions made in the abdomen and perineum. The end of the remaining sigmoid colon is brought out permanently as an opening, called a colostomy, on the surface of the abdomen.

Centralisation of rectal surgery

This operation is one of the less commonly performed by general surgeons, although they are specifically trained to perform this operation. As low case volumes in rectal surgery have been found to be associated with higher complication rates,[2][3] it is often centralised in larger centres,[4] where case volumes are higher.

Laparoscopic approach

There are several advantages in terms of outcomes if the surgery can be performed laparoscopically[5]

Relation to low anterior resection (LAR)

An APR, generally, results in a worse quality of life than the less invasive lower anterior resection (LAR).[6][7] Thus, LARs are generally the preferred treatment for rectal cancer insofar as this is surgically feasible.

Eponym

It is named for William Ernest Miles (1869–1947), an English surgeon who devised it in 1923.[8]

See also

References

  1. ^ American Cancer Society. Detailed Guide: Colon and Rectum Cancer. cancer.org. URL: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4x_Surgery_10.asp?sitearea=. Accessed on: February 5, 2008.
  2. ^ Schrag D, Panageas KS, Riedel E; et al. (November 2002). "Hospital and surgeon procedure volume as predictors of outcome following rectal cancer resection". Ann. Surg. 236 (5): 583–92.  
  3. ^ Marusch F, Koch A, Schmidt U, Pross M, Gastinger I, Lippert H (October 2001). "Hospital caseload and the results achieved in patients with rectal cancer". Br J Surg 88 (10): 1397–402.  
  4. ^ Martling A, Holm T, Cedermark B (2005). "[Skills by training. Education and case volume are strong prognostic factors in rectal cancer surgery]". Lakartidningen (in Swedish) 102 (6): 374–6.  
  5. ^ Simorov A, Reynoso JF, Dolghi Thompson JS, Oleynikov D (2011). "Comparison of perioperative outcomes in patients undergoing laparoscopic versus open abdominoperineal resection". Am J Surg. 202 (6): 666–70.  
  6. ^ McLeod RS (2001). "Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer". Ann. Surg. 233 (2): 157–8.  
  7. ^ Grumann MM, Noack EM, Hoffmann IA, Schlag PM (2001). "Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer". Ann. Surg. 233 (2): 149–56.  
  8. ^ http://www.whonamedit.com/doctor.cfm/3130.html

External links

  • Laparoscopic Abdominoperineal Resection: Basic Surgical Steps - Cleveland Clinic
  • APR Surgery Videos
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and USA.gov, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for USA.gov and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
 
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
 
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.
 


Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.