The abdominoperineal resection is an operation for either rectal or anal cancer and is officially known as abdominoperineal resection of the rectum. It is often abbreviated as AP, APR, and APER resections. The lower bowel abdominoperineal resection is the preferred procedure for low rectal malignancies that involve or are not removed with a distal margin of 2 cm. Under special conditions, young patients can be candidates for a colonel anastomosis, while others may be candidates for wide-ranging local excision and low-grade superficial lesions. All methods including tumour resection and intestine anastomosis in the sacrum hole must be known to a surgeon.
As the operation is of considerable magnitude, the general condition of
the patient needs to be investigated and as improved as much as possible. If
the acute or sub-acute obstruction is not demonstrated, the patient will be on
a liquid diet for one day. Adequate
non-absorbable antibiotics may be administered following the complete
evacuation of the colon by laxatives or purgatives. Parenteral coverage of
antibiotics is given immediately before surgery. It may be recommended that the
bladder or other portions of the genitourinary tract are involved with
cystoscopy in the presence of low-living tumours. Before and after resection of
the neoplasms basal carcinoembryonic antigen levels are measured. Endorectal
ultrasound or MRI plus computed tomography (CT) imaging may be used to evaluate
the extent of extramural spread or binding to nearby organs.
Symptoms
·
A change
in bowel habits like diarrhoea, constipation, or frequent bowel movements
·
Stool dark
brown or bright red blood
·
The pain
of the abdomen
·
Observational
loss of weight
·
Fatigue or
weakness
The treatment of rectal cancer often involves therapies. Operation is
used to cut cancer cells off when possible. Additional treatments, such as
chemotherapy and radiation, can be used to kill remaining cancer cells and
reduce the risk of cancer returning after surgery. If the surgeon is concerned
about cancer not being removed without hurting nearby organs and structures,
the initial treatment of your doctor may be a combination of chemical and
radiation therapy. These combined therapies can decrease cancer and facilitate
removal during surgery.
Rectal cancer is often treated for cancer cell removal by surgery. The
surroundings and stage of your cancer, how aggressive the cancer cells are,
your overall health and preferences depend upon which operation is best for
you.
Rectal cancer surgeries include the following:
The removal of small cancer cells
Very small, colonoscopically, or other specialist types of anus-inserted
rectal cancer can be removed (trans anal local excision). Surgical instruments
can be used to remove cancer and some healthy tissue around it.
Chemotherapy
Drugs are used for the destruction of cancer cells through chemotherapy.
Chemotherapy after surgery may be recommended for rectal cancer to kill any
remaining cancer cells.
Radiation
To kill cancer cells, radiotherapy uses potent sources of energy, such
as X-rays and protons. Radiation therapy is often combined with chemotherapy in
people with rectal cancer, which makes radiation damaging cancer cells more
likely.
Targeted medicinal treatment
Specific abnormalities in cancer cells are focussed on specific
medicines treatments. Targeted drug therapies may cause cancer cells to die by
blocking these abnormalities. Targeted medicines are usually combined with
chemical treatment. Targeted medicines for people with advanced rectal cancer are
typically reserved.
Immunotherapy
Immunotherapy is a medication used to fight cancer by your immune
system. The immune system your body controls cannot attack your cancer because
cancer cells produce proteins that help them clothe themselves away from cells
in the immune system. Immunotherapy works by disrupting the process.
Care of support (palliative)
The focus of palliative care is on pain relief and other serious disease
symptoms. Palliative care specialists work with you, your family and other
physicians to provide an extra support layer that complements your continuous
care. A team of doctors, nurses, and other trained professionals provides
palliative care. Care teams for cancer patients and their families are aimed at
improving life quality.
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