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About The Surgery

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Abdominoperineal Resection Surgery

Abdominoperineal resection is a surgical procedure in which the anus, rectum, and sigmoid colon are removed. This procedure is used to treat cancers located in the rectum or the anus. It is abbreviated as AP resection, APR and APER.

What are the Possible Causes?

Rectal cancer happens when the healthy cells in the rectum start mutation in the DNA. Most of the time, the reason for the multiplication of cells is obscure. When a cell's DNA is damaged by mutation and ends up malignant, cells keep on dividind, especially when the new cells aren't required. As the cells gather, they take the shape of a tumour.

Two genetic causes of rectal cancer are:

Hereditary Nonpolyposis Colorectal cancer (HNPCC): HNPCC, also referred to as Lynch syndrome, multiplies the risk of colon cancer and other cancers. People who are past 50 years of age, tend to develop rectum cancer.

Familial adenomatous polyposis (FAP). FAP is an uncommon disorder that causes you to develop thousands of polyps (abnormal tissue growth) in the lining of colon and rectum. People with FAP are at greater risk of developing colon or rectal cancer before 40 years of age.

What are the Observable Symptoms?

  • Dark red blood in the stool
  • Mucus in stool
  • Abdominal pain
  • Painful bowel movements
  • Iron deficiency
  • Inexplicable rapid weight loss
  • Weakness or fatigue
  • A persistent feeling of your bowel not being empty
  • A shift in your bowel habits, such as diarrhoea, constipation or more-frequent bowel movements

Diagnosis

  • Colonoscopy
    A colonoscopy enables the specialist to take a glimpse inside the whole rectum and colon while a patient under sedation. A colonoscopist is a specialist who has an expertise in conducting this test. In the event that colorectal growth is discovered, a total conclusion that precisely depicts the area and spread of the disease may not be conceivable until the point when the tumour is carefully evacuated.
  • Biopsy
    A biopsy is the removal of a little portion of tissue for examination under a magnifying lens. Different tests may indicate the presence of colorectal cancer, yet biopsy provides the final conclusion. A biopsy might be performed amid a colonoscopy, or it might be done on any tissue that is extracted amid medical procedure.
  • Molecular Testing
    Your specialist may prescribe laboratory tests on a tumour to recognise causes of some particular symptoms, proteins, and different variables which specify the presence of a tumour.
  • Blood Tests
    Since colorectal malignancy frequently spreads into the internal organs or rectum, individuals with the ailment may end up weak. The count of red cells in the blood is measured to test the presence of test. Complete blood count (CBC) can also demonstrate the presence of malignancy.
  • Carcinoembryonic Antigen Test (CEA)
    CEA is an ideal blood test for colorectal tumour's diagnosis. The doctor can also use the test results to determine if a cancer treatment is working. A high amount of CEA in the patient's body after cancer treatment or surgery suggests that the cancer is remaining. It may also mean that cancer has spread to other parts of your body.
  • Computed Tomography (CT or CAT) Scan
    A CT scan makes a 3D photo of the body from inside, utilising x-rays taken from various points. A PC joins these pictures into a point by point, cross-sectional view that demonstrates any anomalies or tumours. A CT scan can be utilised to gauge the tumour's size. In some cases, a unique colour called a differentiation medium is given before the output to provide detailed pictures.
  • Magnetic Resonance Imaging (MRI)
    An MRI utilises magnetic fields, not x-rays, to create itemised pictures of the body. X-ray can be utilised to gauge the tumor size. A unique color called a complexity medium is given before the sweep to make a clearer picture. This colour can be infused into a patient's vein or given as a pill to swallow. X-ray is the best imaging test to discover the location of colorectal cancer.
  • Ultrasound
    Ultrasound utilises sound waves to make a photo of the inside organs to see whether a tumour has spread. Endorectal ultrasound is ordinarily used to discover how profoundly rectal malignancy has developed and can be utilised to help design treatment. In any case, this test can't precisely identify malignancy that has spread to adjacent lymph nodes or past the pelvis. Ultrasound can likewise be utilised to see the liver, although CT outputs or MRIs are favoured because they are better at findingtumours in the liver.
  • Chest X-ray
    An x-ray is a diagnostic method which creates the images of the structures within the body, utilising a little radiation. This test can enable specialists to see whether the growth has spread to the lungs.
  • Positron Emission Tomography (PET)
    A PET scan typically joined with a CT scan is called a PET-CT scan. A PET scan is an approach to make pictures of organs and tissues inside the body. A little measure of a radioactive sugar substance is infused into the patient's body. This sugar substance is taken up by cells, since they utilise a lot of energy. The presence of radioactive substance is more at the place where cancerous cells are present. A scanner at that point identifies this substance to deliver pictures of within the body.

How is the Abdominoperineal Resection done?

  • Removing the sigmoid colon and rectum
    Your surgeon will complete multiple steps before extracting the anus, rectum, and sigmoid colon. The surgeon divides the main blood vessels that serve the diseased sections of the bowel. Once the removal is done, the surgeon frees the sigmoid colon and rectum from their attachments. The sigmoid colon is finally detached from the large intestine.
  • Anus Removal
    After the sigmoid colon and rectum are removed, the surgeon operates on the area between the legs (perineal region) to cut away the anus.
  • Making the Stoma The surgeon creates a stoma and a small section of skin is removed from the incision site. The open end of the colon is pulled through the incision to the surface of the skin. The stoma is sutured in its place. The abdominal cavity is then rinsed out. A temporary drainage tube is inserted into one of the lower abdominal incision sites. Finally, the abdominal cavity is closed by stitching.

What are the Risks and Complications after Surgery?

The possible risks or complications that may appear during the surgery are:

  • Infection
  • Excessive bleeding
  • Cardiopulmonary complications
  • Accidental damage to the ureter
  • Blood clot formation in the legs
  • Problems that may arise from a colostomy

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