Abdominoperineal Resection
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Abdominoperineal Resection
An abdomino perineal resection, formally known as abdominoperineal resection of the rectum and abdominoperineal excision of the rectum is a surgery for rectal cancer or anal cancer. It is frequently abbreviated as AP resection, APR and APER. Indication and descriptionSee image on National Cancer Institute website
The principal indication for AP resection is a rectal carcinoma situated in the distal (lower) one-third of the rectum. Other indications include recurrent or residual anal carcinoma () following initial, usually definitive combination chemoradiotherapy. APRs involves removal of the

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Abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior (anatomy), posterior tagma (biology), tagma of the body; it follows the thorax or cephalothorax. In humans, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between Lumbar vertebrae, L5 and Vertebra#Sacrum, S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear. In vertebrates, the abdomen is a large body c ...
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Lymph Nodes
A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that include B and T cells. Lymph nodes are important for the proper functioning of the immune system, acting as filters for foreign particles including cancer cells, but have no detoxification function. In the lymphatic system a lymph node is a secondary lymphoid organ. A lymph node is enclosed in a fibrous capsule and is made up of an outer cortex and an inner medulla. Lymph nodes become inflamed or enlarged in various diseases, which may range from trivial throat infections to life-threatening cancers. The condition of lymph nodes is very important in cancer staging, which decides the treatment to be used and determines the prognosis. Lymphadenopathy refers to glands that are enlarged or swollen. When inflamed or enlarged, lymph nodes can be fi ...
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Cleveland Clinic
Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, as well as 11 affiliated hospitals, 19 family health centers in Northeast Ohio, and hospitals in Florida and Nevada. International operations include the Cleveland Clinic Abu Dhabi hospital in the United Arab Emirates and Cleveland Clinic Canada, which has two executive health and sports medicine clinics in Toronto."Facts & Figures"
Cleveland Clinic.
Another hospital campus in the United Kingdom, Cleveland Clinic London, opened to outpatients in 2021 and is scheduled to fully open in 2022. Tomislav Mihaljevic is the president and CEO. Cleveland Cl ...
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William Ernest Miles
William Ernest Miles (15 January 1869 – 24 September 1947) was an English surgeon known for the Miles' operation: an abdomino-perineal excision for rectal cancer. Sources differ as to whether Miles was born in Trinidad or in Uppingham, England. He received his medical education at St Bartholomew's Hospital, from where he graduated in 1891. At age 25, he became a fellow of the Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. The .... He became interested in rectal cancer under the influence of Harrison Cripps, whose distinguished career at St Bartholomew's was focused on rectal and abdominal surgery. Formerly, surgery for rectal cancer was by perineal excision, which was less efficient in removing neoplastic tissue but easier to perform and carrie ...
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Lower Anterior Resection
A lower anterior resection, formally known as anterior resection of the rectum and colon and anterior excision of the rectum or simply anterior resection (less precise), is a common surgery for rectal cancer and occasionally is performed to remove a diseased or ruptured portion of the intestine in cases of diverticulitis. It is commonly abbreviated as LAR. LARs are for cancer in the proximal (upper) two-thirds of the rectum which lends itself well to resection while leaving the rectal sphincter intact. Relation to abdominoperineal resection LARs, generally, give a better quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ... than abdominoperineal resections (APRs). Thus, LARs are generally the preferred treatment for rectal cancer insofar as this is surgically feasibl ...
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Quality Of Life
Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". Standard indicators of the quality of life include wealth, employment, the environment, physical and mental health, education, recreation and leisure time, social belonging, religious beliefs, safety, security and freedom. QOL has a wide range of contexts, including the fields of international development, healthcare, politics and employment. Health related QOL (HRQOL) is an evaluation of QOL and its relationship with health. Engaged theory One approach, called engaged theory, outlined in the journal of ''Applied Research in the Quality of Life'', posits four domains in assessing quality of life: ecology, economics, politics and culture. In the domain of culture, for example, it includes the following subdomains of ...
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General Surgeon
General surgery is a surgical specialty that focuses on alimentary canal and abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland. They also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral artery disease and hernias and perform endoscopic procedures such as gastroscopy and colonoscopy. Scope General surgeons may sub-specialize into one or more of the following disciplines: Trauma surgery In many parts of the world including North America, Australia and the United Kingdom, the overall responsibility for trauma care falls under the auspices of general surgery. Some general surgeons obtain advanced training in this field (most commonly surgical critical care) and specialty certification surgical critical care. General surgeons must be able to deal initially with almost any surgical emergency. Often, they are the first port of cal ...
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Colostomy
A colostomy is an opening ( stoma) in the large intestine (colon), or the surgical procedure that creates one. The opening is formed by drawing the healthy end of the colon through an incision in the anterior abdominal wall and suturing it into place. This opening, often in conjunction with an attached ostomy system, provides an alternative channel for feces to leave the body. Thus if the natural anus is unavailable for that function (for example, in cases where it has been removed in the fight against colorectal cancer or ulcerative colitis), an artificial anus takes over. It may be reversible or irreversible, depending on the circumstances. Uses There are many reasons for this procedure. Some common reasons are: * A part of the colon has been removed, e.g. due to colon cancer requiring a total mesorectal excision, diverticulitis, injury, etc., so that it is no longer possible for feces to exit via the anus. * A part of the colon has been operated upon and needs to be 'r ...
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Stoma (medicine)
In anatomy, a stoma (plural stomata or stomas) is any opening in the body. For example, a mouth, a nose, and an anus are natural stomata. Any hollow organ can be manipulated into an artificial stoma as necessary. This includes the esophagus, stomach, duodenum, ileum, colon, pleural cavity, ureters, urinary bladder, and renal pelvis. Such a stoma may be permanent or temporary. Surgical procedures that involve the creation of an artificial stoma have names that typically end with the suffix "-ostomy", and the same names are also often used to refer to the stoma thus created. For example, the word "colostomy" often refers either to an artificial anus or the procedure that creates one. Accordingly, it is not unusual for a stoma to be called an ostomy (plural ostomies), as is the norm in wound, ostomy, and continence nursing. Gastrointestinal stomata Stomata are created in particular in surgical procedures involving the gastrointestinal tract (GIT) or gastrointestinal system ( ...
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Perineum
The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), including the perineal body and surrounding structures. There is some variability in how the boundaries are defined. The perineal raphe is visible and pronounced to varying degrees. The perineum is an erogenous zone. The word perineum entered English from late Latin via Greek περίναιος ~ περίνεος ''perinaios, perineos'', itself from περίνεος, περίνεοι 'male genitals' and earlier περίς ''perís'' 'penis' through influence from πηρίς ''pērís'' 'scrotum'. The term was originally understood as a purely male body-part with the perineal raphe seen as a continuation of the scrotal septum since masculinization causes the development of a large anogenital distance in men, in comparison to the corresponding lack ...
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Sigmoid Colon
The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''sigma'' + ''-oid''). This part of the colon normally lies within the pelvis, but due to its freedom of movement it is liable to be displaced into the abdominal cavity. Structure The sigmoid colon begins at the superior aperture of the lesser pelvis, where it is continuous with the iliac colon, and passes transversely across the front of the sacrum to the right side of the pelvis. It then curves on itself and turns toward the left to reach the middle line at the level of the third piece of the sacrum, where it bends downward and ends in the rectum. Its function is to expel solid and gaseous waste from the gastrointestinal tract. The curving path it takes toward the anus allows it to store gas in the superior arched portion, enabling the co ...
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Perineum
The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), including the perineal body and surrounding structures. There is some variability in how the boundaries are defined. The perineal raphe is visible and pronounced to varying degrees. The perineum is an erogenous zone. The word perineum entered English from late Latin via Greek περίναιος ~ περίνεος ''perinaios, perineos'', itself from περίνεος, περίνεοι 'male genitals' and earlier περίς ''perís'' 'penis' through influence from πηρίς ''pērís'' 'scrotum'. The term was originally understood as a purely male body-part with the perineal raphe seen as a continuation of the scrotal septum since masculinization causes the development of a large anogenital distance in men, in comparison to the corresponding lack ...
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