Abstract
With the development of total mesorectal excision (TME) as the gold standard procedure in rectal cancer, leading to substantially improved results after low anterior resection (LAR), many surgeons advocated low or ultralow anterior resection for tumours of the lower rectum. It has been shown that these procedures are feasible and oncologically safe if the tumour can be removed with clear distal and circumferential margins [1]. Total mesorectal excision (TME) and restorative resections with an anastomosis is feasible in many patients with rectal cancer. However, patients with poor anal function and very low advanced tumours are not suitable for restorative procedures. Abdomino-perineal resections may be preferable in such situations. This chapter describes the indications and technical details for different types of abdomino-perineal resections.
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References
MacFarlane JK, Ryall RD, Heald RJ. Mesorectal excision for rectal cancer. Lancet. 1993;341(8843):457–60.
Bregendahl S, Emmertsen KJ, Lous J, Laurberg S. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Color Dis. 2013;15(9):1130–9.
Holm T, Ljung A, Häggmark T, Jurell G, Lagergren J. Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg. 2007;94:232–8.
Nilsson PJ. Omentoplasty in abdominoperineal resection: a review of the literature using a systematic approach. Dis Colon Rectum. 2006;49(9):1354–61.
den Dulk M, Putter H, Collette L, Marijnen CA, Folkesson J, Bosset JF, et al. The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer. Eur J Cancer. 2009;45(7):1175–83.
Sayers AE, Patel RK, Hunter IA. Perineal hernia formation following extralevator abdominoperineal excision. Color Dis. 2015;17(4):351–5.
Bullard KM, Trudel JL, Baxter NN, Rothenberger DA. Primary perineal wound closure after preoperative radiotherapy and abdominoperineal resection has a high incidence of wound failure. Dis Colon Rectum. 2005;48(3):438–43.
Khoo AK, Skibber JM, Nabawi AS, Gurlek A, Youssef AA, Wang B, et al. Indications for immediate tissue transfer for soft tissue reconstruction in visceral pelvic surgery. Surgery. 2001;130(3):463–9.
Nisar PJ, Scott HJ. Myocutaneous flap reconstruction of the pelvis after abdominoperineal excision. Color Dis. 2009;11(8):806–16.
Anderin C, Martling A, Lagergren J, Ljung A, Holm T. Short-term outcome after gluteus maximus myocutaneous flap reconstruction of the pelvic floor following extra-levator abdominoperineal excision of the rectum. Color Dis. 2012;14(9):1060–4.
Foster JD, Pathak S, Smart NJ, Branagan G, Longman RJ, Thomas MG, et al. Reconstruction of the perineum following extralevator abdominoperineal excision for carcinoma of the lower rectum: a systematic review. Color Dis. 2012;14(9):1052–9.
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Holm, T. (2021). Abdominoperineal Excision of the Rectum. In: Hohenberger, W., Parker, M. (eds) Lower Gastrointestinal Tract Surgery. Springer Surgery Atlas Series. Springer, Cham. https://doi.org/10.1007/978-3-030-60827-9_16
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DOI: https://doi.org/10.1007/978-3-030-60827-9_16
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