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Results for “Abdominoperineal resection”

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At least 19 recordsLinked to original sources

PubMed1977

Combined abdominoperineal resection.

Abdominoperineal resection has long been recognized as a procedure with formidable morbidity. Through meticulous dissection, use of proper tissue planes, attention to location of urologic and neurologic structure, careful hemostasis, and appropriate postoperative measures, most of the complications outlined in this article can be avoided. Should a complication develop, close surveillance and early recognition coupled with the appropriate management can still offer the patient a satisfactory recovery.

Abdomen↗

PubMed2026

Intersphincteric resection versus abdominoperineal resection for lower rectal cancer: A systematic review and meta-analysis.

BACKGROUND: The optimal surgical approach for lower rectal cancer (LRC) remains debated, particularly between intersphincteric resection (ISR) and abdominoperineal resection (APR). While ISR offers potential sphincter preservation, its oncological efficacy compared to APR is unclear. METHODS: A systematic review was conducted to compare clinical and oncological outcomes of ISR versus APR in LRC patients. On December 8, 2024, a comprehensive search of Medline, Embase, Cochrane Library, Scopus, and Web of Science identified 24 retrospective studies involving 4502 patients. Key outcomes analyzed included positive circumferential resection margin (CRM), number of harvested lymph nodes (LNs), local recurrence (LR), length of hospital stay (LOS), early postoperative complications, and survival. RESULTS: Twenty-four retrospective studies involving 4502 patients (ISR: 2266 (50.3%) and APR: 1558 (34.6%)) met the eligibility criteria. ISR was associated with significantly lower rates of positive CRM (risk ratio (RR): 0.41, p < 0.001), decreased early postoperative complications (RR: 0.76, p < 0.001), lower LR (RR: 0.63, p = 0.0038), and improvement in five-year overall survival (5YOS) (hazard ratio (HR) = 0.42, p < 0.001) and five-year disease-free survival (5YDFS) (HR = 0.59, p < 0.001). CONCLUSIONS: ISR demonstrates several advantages over APR in selected LRC patients, including lower rates of positive CRM, fewer early postoperative complications, reduced LR, greater LN harvest, shorter LOS, and improved long-term survival outcomes (5YOS and 5YDFS). Therefore, ISR can be considered a safe and effective alternative to APR in appropriately chosen patients, with careful patient selection and surgical expertise remaining essential.

Humans↗

PubMedDate not supplied

Surgical treatment of rectal carcinoma: results of anterior resection vs. abdominoperineal resection at a community hospital.

Explore the source record for details and available documents.

Adenocarcinoma↗

PubMed1976

Abdominoperineal resection following anterior resection.

A series of 11 patients undergoing abdoninoperineal resection for "suture line recurrence" following anterior resection is presented. Five-year survival is 10%. Technically, the procedure is difficult and major problems are encountered, including large blood loss and ureteral complications. These patients had an inadequate distal margin of resection at the time of anterior resection. The survival of this group of patients underscores the importance of making the correct judgment about anterior or abdominoperineal resection at the time of the initial presentation of the patient. The phrase "suture line recurrence" is a misnomer; all of these patients had advanced pelvic malignancy. If the adequacy of the distal margin is questionable or a distal margin of 5 cm cannot be obtained safely at the time of anterior resection, abdominoperineal resection should be performed, as the opportunity for cure of a recurrence should this rule be compromised is limited.

Female↗

PubMed1978

Abdominoperineal resection in the octogenarian.

Traditionally, abdominoperineal resection has been the accepted surgical therapy for anorectal carcinoma. A review is presented of the experience with this procedure at the University of Iowa Hospitals, involving 52 patients (33 men, 19 women) over the age of 80 (median, 81 years). The most common symptoms were: rectal bleeding in 35 patients, change in character of stool in 35, weight loss in 13, and abdominal pain in 7. A rectal mass was palpable in 45 patients and visible by sigmoidoscopy in 3 others. Of the 52 patients, 23 percent (12/52) died before postoperative discharge from the hospital, and 32 percent of the survivors had significant postoperative complications. The most lethal complications were related to problems of surgical technique. The median survival time for patients discharged from the hospital was 22 months, with causes of death being equally distributed between recurrent carcinoma and other disorders. Abdominoperineal resection remains an acceptable method for treatment of anorectal carcinoma in the aged (80 or older) provided it is carried out with meticulous technique and careful selection of the patients.

Abdomen↗

PubMed1976

Abdominoperineal resection: Treatment of choice for carcinoma of the rectum.

Abdominoperineal resection cure adenocarcinoma of the rectum was performed in 62 patients between 1965 and 1969 at the Winnipeg General Hospital. Mean age was 64, ranging from 41 to 83; 40 patients were male and 22 female. Distribution by Dukes' staging was: A, 11; B, 28; C, 23. Complications occurred in 22 patients (35%). Average hospital stay was 29 days, 27 days in uncomplicated patients and 36 days in those with complications. There were two deaths, a 3.2% operative mortality rate. Sixty of the 62 patients were available for 5-year followup. Crude survival rate was 52%: A, 91%; B, 59%; C, 25%. Two patients died of an operation that permanently cured three patients in whom disease had spread beyond local confines. Abdominoperineal resection offered a 52% 5-year survival rate, increased the rate of cures in the unstaged patient by at least 5% over that afforded by local therapy, gave a 14% chance of cure in stage C disease compared with 0% with local therapy, and, compared with local therapy, was at least 67% more likely to offer cure than to kill in the event of disease spread to regional lymph nodes.

Abdomen↗

PubMed1977

Abdominoperineal resection in the treatment of devascularizing rectal injuries.

Local debridement, drainage, and diverting colostomy, with or without primary repair of the rectum, have been considered to be the standard treatment for most rectal injuries, but they are not sufficient for those patients sustaining uncontrollable bleeding or extensive rectal devascularization. This report assessed the indications and results of abdominoperineal resection of the rectum in these patients. Ten patients who were victims of explosive trauma presented with massive perineal injuries and extensive rectal devascularization. Six of these were treated with local debridement of necrotic tissue, pararectal drainage, antibiotics, and colostomy. Five of the six patients initially treated by colostomy died after operation from hemorrhage or sepsis. The sixth patients, who survived, had an abdominal resection of the rectum performed 5 days after the colostomy for removal of a gangrenous rectum. All five of those who underwent abdominoperineal resection survived (p less than 0.01). Increasing violence in the life patterns of modern society enhances the possibility of occurrence of this type of lesion, previously limited to military practice. The need for careful investigation of rectal viability is emphasized. Primary abdominoperineal resection of the rectum is advised when extensive devascularization has occurred.

Abdomen↗

PubMed2026

Minimally invasive versus open abdominoperineal resection and the risk of postoperative perineal hernia: a systematic review and meta-analysis.

BACKGROUND: The impact of minimally invasive surgery on the risk of postoperative perineal hernia after abdominoperineal resection (APR) or extralevator abdominoperineal excision (ELAPE) remains uncertain. This study compares perineal hernia rates and perioperative outcomes between minimally invasive and open approaches. METHODS: PubMed, Scopus, Web of Science, and Cochrane Library were searched through June 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. A Bayesian meta-analysis was additionally performed for the primary outcome. RESULTS: Four comparative observational studies involving 763 patients were included; 249 underwent minimally invasive APR/ELAPE, and 514 underwent open APR/ELAPE. Postoperative perineal hernia was significantly more frequent following minimally invasive surgery (OR 4.13; 95% CI 2.24-7.61; p < 0.001). Intraoperative blood loss was significantly lower in the minimally invasive group (MD - 156.5 mL; 95% CI - 298.4 to - 14.5; p = 0.03), as was operative time (MD - 41.7 min; 95% CI - 60.8 to - 22.5; p < 0.01). No significant differences were observed in hospital stay (MD - 2.5 days; 95% CI - 5.4 to 0.4; p = 0.09) or 30-day readmission rates (OR 1.41; 95% CI 0.82-2.42; p = 0.209). Bayesian analysis yielded a posterior mean OR of 4.04 (95% CrI 1.96-8.36), corresponding to a 99.9% posterior probability that minimally invasive surgery increases the risk of postoperative perineal hernia. CONCLUSION: Minimally invasive APR/ELAPE was associated with an increased risk of postoperative perineal hernia compared with the open approach. Strategies to reduce this complication while preserving the benefits of minimally invasive surgery warrant further investigation.

Humans↗

PubMed1977

Review of abdominoperineal resections for cancer.

One hundred eighty-six consecutive abdominoperineal resections for primary carcinoma of the anus, rectum, or sigmoid colon performed at Charity Hospital of Louisiana at New Orleans between January 1, 1963 and December 31, 1974 were reviewed. The operative mortality was 16 per cent. Complications during the same hospitalization occurred in 70 percent of the patients. Although most of the complications were minor, 22 percent did require some form of surgical intervention. Twenty-nine percent of the patients who were discharged developed late mechanical or cancer-caused complications which required surgical correction. A history of congestive heart failure or a significant weight loss were the most consistent preoperative findings in the operative mortality group. The overall five year survival rate was 25 percent. White females with no history of weight loss had the best long-term prognosis. Better survival in white patients can be accounted for by the less advanced lesions in these patients. No such difference between male and female patients could be demonstrated. Better selection of surgical candidates with alternate forms of therapy for poor risk patients have probably been the most significant factors in decreasing the operative mortality from 21 percent in the first six years of the study to 9 percent in the last six years. Primary closure of the perineal wound would appear to be of value in decreasing operative morbidity.

Abdomen↗

PubMed1976

Genitourinary complications of abdominoperineal resection.

The genitourinary complications of 86 consecutive cases of abdominoperineal resection at the University of Oklahoma Health Sciences Center are described. Vesical dysfunction was the most common problem, occurring in 11 patients in our series. Eight required prostatectomy for urinary retention. The significance and treatment of vesical dysfunction is somewhat controversial, but an attempt to document the cause should be made in every case. Voiding symptoms and results of intravenous urogram with postvoiding films, cystogram, cystometrogram, and cystoscopy are diagnostically pertinent. Accordingly, preoperative urologic evaluation is indispensable to proper treatment of rectosigmoid carcinoma.

Abdomen↗

PubMed1978

The incidence and consequences of damage to the parasympathetic nerve supply to the bladder after abdominoperineal resection of the rectum for carcinoma.

Fifty-one patients undergoing abdominoperineal resection of the rectum for carcinoma were studied with regard to bladder function after surgery. Fifty-nine per cent had motor denervation of the bladder due to tumour or operative damage to the pelvic parasympathetic nerves and this produced symptoms of incomplete bladder emptying requiring treatment in 90% of this group. The factors affecting the incidence of nerve damage were discussed. The long-term effect of parasympathetic nerve damage was investigated and the management is discussed.

Cholinergic Fibers↗

PubMed1979

Medial deviation of the pelvic ureters after abdominoperineal resection of the rectum.

Pre- and postoperative urograms of 47 patients undergoing abdominoperineal resection were reviewed for ureteral deviation and obstruction. Postoperative medial deviation occurred in 11 patients (23.4%). Both ureters were involved in six of these patients. Ureteral deviation was identified as early as 3 days after surgery. Obstruction of the ureters occurred in four patients and was due to tumor in three of these.

Abdomen↗

PubMed1978

Endorectal mucosal resection without proctectomy as an adjunct to abdominoperineal resection for nonmalignant conditions: clinical experience with five patients.

Five patients with chronic ulcerative colitis underwent endorectal excision of the rectal mucosa without removing the rectal muscle in combination with total colectomy and cutaneous ileostomy. This operative technique will cure the patient of the primary disease and obviates many of the usual unpleasant complications following total proctectomy, such as prolonged perineal drainage and sexual and bladder dysfunction. It has the further advantages of lower operative blood loss and earlier safe ambulation. On the basis of favorable clinical experience with these patients, we believe that the operation warrants further clinical trial in patients who have biopsy-proven ulcerative colitis without severe rectal ulcerations as well as in certain other nonmalignant conditions originating in the rectal mucosa.

Adolescent↗

PubMed1976

Urologic complications following abdominoperineal resection of the rectum.

Perusal of the records of 111 consecutive patients who underwent abdominoperineal resection of the rectum for malignant diseases of the rectum or anal canal for postoperative urologic complications revealed that the urethra had been injured in two patients, the bladder in none, and the ureter in five. In only two of these last five patients was the late result of treatment of the ureteric injury satisfactory. The late result of treatment of the two urethra injuries was good. All the patients had been treated with an indwelling catheter for at least ten days after the operation. About one third of the patients still had disturbances of micturition two weeks after the operation, but only one required a permanent indwelling catheter.

Adult↗

PubMed1979

Pelvic recurrence of cancer after abdominoperineal resection of the rectum.

Records of 122 patients with carcinoma of the rectum treated by abdominoperineal resection at M. D. Anderson Hospital and Tumor Institute between 1967 and 1972 were reviewed with regard to local pelvic recurrence and survival. Local recurrence rates for men were: stage IB, 14%; II, 23%; and III, 21%; and for women: IB, 6%; II, 15%; and III, 35%. Forty-one percent of the male patients and 54% of female patients had nodal metastasis at the time of their initial operation. The high pelvic recurrence rates in women may lend support to consideration of a posterior exenteration in all female patients with advanced carcinoma of the rectum.

Adenocarcinoma↗

PubMed1977

Abdominoperineal resection for carcinoma in the community hospital.

Stimulated by a report in 1974, we have reviewed all abdominoperineal resections in a Univeristy-affiliated community hospital. From 1964--1973, 67 such procedures were performed. There were 65 adenocarcinomas, one squamous cell cancer, and one carcinoid tumor. Dukes' classification was A-4, B-22, C-39, D-4. Postoperative complications occurred in 55.1% of patients. Late complications occurred in 22% of patients. Five-year follow-up was possible in 34 patients with an overall survival of 50%.

Abdomen↗

PubMed1976

A study of perineal wound healing after abdominoperineal resection.

A comparative study of 53 cases has revealed that a technique of complete primary closure of the perineal wound after abdominoperineal resection of the rectum and anal canal appears to be a superior, more rational approach than other orthodox techniques. (It is unsuitable for any case contaminated with pus or faeces during operation.) Redivac apparatus used through a separate route for continuous drainage from the sacral cavity has made the postoperative care easier for nurses and surgeons and this period more comfortable for the patient. It provides a simple method compared with other suction apparatus used for the same purpose. Of the 53 cases, 12 were operated on using a traditional technique involving the closure of the perineal wound around a tube drain connected to an underwater seal, while in the remaining 41 the approach described here was used. Primary healing of the perineal wound with the later approach was obtained in about 88 per cent. With the other technique the figures were 34 and 66 per cent respectively for early healing within 3 weeks and delayed healing between 3-8 weeks. Primary healing of the perineal wound reduces the total stay in hospital and the morbidity.

Anal Canal↗

PubMed1978

Use of the carbon dioxide laser in an abdominoperineal resection for epidermoid anal carcinoma: a case report.

An abdominoperineal excision of the rectum was performed on a 52-year-old male who had epidermoid anal carcinoma. A steel scalpel was utilized for the abdominal component, but the entire perineal resection was accomplished with a carbon dioxide laser beam. We believe this to be the first reported case of an abdominoperineal resection using this new modality, which may become a useful and modern adjunct in extirpative surgery. The haemostatic effects of the laser were well demonstrated in our patient.

Anus Neoplasms↗