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Abdominoperineal Resection (APR) Treatment in India

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Recommended Doctors for Abdominoperineal Resection (APR) View All View All

Dr Nitin Leekha
Dr Nitin Leekha

Associate Director - Surgical Oncology

CONSULTS AT

Jaypee Hospital

EXPEREIENCE :
12 years
SURGERIES :
9000+

Treatment Starting at $450

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Treatment Starting at $450

Dr Nitin Leekha
Dr Nitin Leekha

Associate Director - Surgical Oncology

CONSULTS AT

Jaypee Hospital

EXPEREIENCE :
12 years
SURGERIES :
9000+
Dr. Alihan Gurkan
Dr. Alihan Gurkan

Head-general Surgery Department

CONSULTS AT

Memorial Antalya Hospital

EXPEREIENCE :
20+ years
SURGERIES :
NA

Treatment Price on request

Free Text Consult

Treatment Price on request

Dr. Alihan Gurkan
Dr. Alihan Gurkan

Head-general Surgery Department

CONSULTS AT

Memorial Antalya Hospital

EXPEREIENCE :
20+ years
SURGERIES :
NA

Introduction

Abdominoperineal Resection (APR) is a complex surgical procedure that plays a crucial role in the treatment of certain colorectal conditions. Developed over the years with advancements in medical science and surgical techniques, APR has become a valuable tool in managing specific diseases, particularly in cases of rectal cancer and some other pelvic malignancies. In this blog, we will explore the essential aspects of Abdominoperineal Resection, including its indications, procedure, recovery, and potential impact on patients' lives.

Understanding Abdominoperineal Resection (APR)

Abdominoperineal Resection is a surgical procedure primarily used to treat rectal cancer or other aggressive pelvic tumors. It involves the removal of the rectum, anus, and surrounding tissues in the pelvic area. The main goal of this operation is to excise the cancerous growth completely, prevent further spread of the disease, and potentially offer a cure for patients with localized disease.

Indications for APR

APR is typically considered when rectal cancer is located too close to the anal sphincter, making it challenging to perform a sphincter-saving procedure, such as a low anterior resection. Other indications for APR include:

  • Locally advanced rectal cancer: When the tumor extends into the anal sphincter or involves nearby structures, making a sphincter-saving procedure infeasible.
  • Recurrent rectal cancer: If cancer returns after previous treatment, APR might be necessary to achieve complete removal of the tumor.
  • Persistent anal cancer: In some cases of anal cancer, APR may be required to eradicate the disease completely.
  • Rare pelvic tumors: APR can be employed to treat certain pelvic malignancies that are non-responsive to other treatment options.

The APR Procedure

The Abdominoperineal Resection procedure is a major surgery performed under general anesthesia. It typically involves two surgical teams - one working on the abdominal part and the other on the perineal (anal) area. The steps of the surgery include:

  • Abdominal Incision: The surgeon starts by making an incision in the lower abdomen to gain access to the affected area.
  • Dissection and Removal: The rectum, anus, and surrounding lymph nodes are carefully dissected and removed, ensuring complete removal of the cancerous tissue.
  • Stoma Creation: After the rectum and anus are removed, the surgeon creates a stoma (a small opening) on the abdominal wall to divert waste into a colostomy bag. This temporary or permanent stoma allows the patient to eliminate waste after the removal of the rectum.
  • Perineal Incision: Another incision is made in the perineal area to facilitate the removal of the anus and part of the anal sphincter.
  • Closure and Reconstruction: The perineal incision is closed, and the abdominal incision is sutured after ensuring all the necessary structures have been removed.

Recovery and Rehabilitation

The recovery period after Abdominoperineal Resection is significant and may vary from patient to patient. Initially, patients might experience discomfort, pain, and limited mobility. They will need to adapt to living with a colostomy bag, which can be an emotional adjustment for many individuals. However, with time, most patients can resume regular activities and learn to manage the colostomy effectively.

To support patients during this process, a multidisciplinary approach is crucial. Patients often work closely with specialized ostomy nurses, dietitians, and physical therapists to ensure proper stoma care, nutrition, and rehabilitation.

Emotional and Psychological Impact

Living with a colostomy bag can have a profound psychological impact on patients. They may experience feelings of anxiety, embarrassment, or depression. In such cases, counseling and support groups can be immensely helpful in addressing emotional concerns and building a supportive community of individuals who have undergone similar experiences.

Conclusion

Abdominoperineal Resection (APR) is a critical surgical procedure in the management of specific colorectal conditions, particularly rectal cancer. While it poses significant challenges for patients, it can be life-saving and offer a chance for cure in certain cases. The surgery, coupled with comprehensive post-operative care, aims to enhance patients' quality of life and restore their physical and emotional well-being.

As medical research continues to advance, it is essential to explore innovative techniques that further improve outcomes and minimize the impact of APR on patients' lives. Ultimately, a combination of medical expertise, emotional support, and patient determination paves the way for a successful recovery and a brighter future for those who undergo this intricate surgical intervention.

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FAQs

APR is primarily used to treat rectal cancer, especially when the tumor is located close to the anal sphincter, making it difficult to perform sphincter-saving procedures. It can also be employed for other aggressive pelvic tumors and recurrent rectal cancer.
The recovery period after APR surgery is significant and varies from patient to patient. Initially, patients may experience discomfort and pain, but with time and proper care, they can resume regular activities. Learning to manage a colostomy bag, emotional adjustment, and rehabilitation are important aspects of the recovery process.
In some cases, the colostomy might be permanent, especially if complete removal of the rectum and anus is necessary for tumor control. However, in other cases, it might be temporary, and a reversal surgery can be considered once the surgical site heals and cancer treatment is successful.
The hospital stay after APR surgery typically ranges from 5 to 10 days, depending on individual factors and the complexity of the surgery. Patients may need to stay longer if they experience any postoperative complications.
With time and proper healing, most patients can resume normal activities, including work, exercise, and social interactions. However, activities involving heavy lifting or intense physical strain should be approached with caution and after consultation with the surgical team.
In the immediate postoperative period, a soft and easily digestible diet is usually recommended. As the patient's condition improves, they can gradually reintroduce a regular diet. However, it's essential to work with a dietitian to ensure adequate nutrition and manage any specific dietary needs.
Living with a colostomy bag can have a significant emotional impact on patients. Many hospitals offer counseling services and support groups to help patients cope with emotional challenges. Connecting with others who have undergone similar surgeries can provide valuable insights and emotional support during the recovery process.

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