Laparoscopic abdominoperineal resection is a surgery to treat cancer low in the rectum or in the anus, close to the sphincter muscles. This surgery, which removes the anus, rectum, and sigmoid colon, is a less invasive technique that calls for five or six small incisions rather that one large incision.
An abdominoperineal resection (APR) is a surgery in which the anus, rectum and sigmoid colon are removed. This procedure is most often used to treat rectal cancers located very low in the rectum. Often this surgery occurs after you have completed radiation and/or chemotherapy treatments.
Your healthcare provider will help you prepare for your abdominoperineal resection. They will talk to you about your medical history and discuss any prescription drugs or supplements you’re taking. You should also tell your healthcare provider if you have sleep apnea. If you use a CPAP device, bring it with you the day of your surgery.
It’s recommended that you don’t smoke or drink alcohol in the weeks leading up to your surgery. These habits can hinder your healing and cause serious complications. It’s important to be honest with your healthcare provider about how much you drink or smoke. They can help you plan ahead for a successful recovery.
This procedure is performed under general anesthesia at a hospital. Abdominoperineal resection steps include:
Generally, abdominoperineal resection surgery takes about two to three hours. This timeframe can vary depending on your specific situation.
Following abdominoperineal resection surgery, most people stay in the hospital for several days. You’ll be fitted with an ostomy pouch immediately after surgery. However, it takes a few days for your digestive system to become active again. Your diet is slowly increased from liquids to solid foods as your intestines start functioning.
While you are recovering in the hospital, your medical team will give you instructions for abdominoperineal resection postoperative care. This includes how to properly care for your stoma and how to change your ostomy bag when you return home from the hospital. Colostomy irrigation may be an option to help regulate bowel movements after the procedure.
There are several benefits to performing this procedure laparoscopically. Compared to traditional open surgery, the laparoscopic technique:
In rare instances, people can develop a perineal hernia after abdominoperineal resection. This is a weakness where the skin is closed after the anus is removed. This issue can be addressed with surgical hernia repair if necessary. Other abdominoperineal resection complications include:
Treatment for these postoperative complications depends on the severity of the issue. Your healthcare provider may recommend a number of treatments, from antibiotics to corrective surgery.
On average, recovery after abdominoperineal resection surgery takes about three to six weeks. This timeline can vary depending on your health history, type of surgery completed and other factors.
Ask your healthcare provider when it’s safe for you to return to school, work or other activities. People with desk jobs may be able to return sooner than people who have physically demanding jobs.
If you’ve undergone abdominoperineal resection, be sure to call your healthcare provider if any worrisome symptoms occur. Symptoms may include:
A note from Cleveland Clinic
Hearing that you need abdominoperineal resection surgery can be scary. Talk with your healthcare provider about any questions or concerns you have. You may also want to consider joining a support group. Learning what to expect can help you prepare for your procedure and maximize your quality of life after recovery.
Last reviewed by a Cleveland Clinic medical professional on 08/02/2021.
Learn more about our editorial process.