Apr Surgery

APR Surgery: A Comprehensive Guide for Patients

What is APR Surgery?

APR surgery, also known as abdominoperineal resection, is a major surgical procedure to remove the rectum and anus due to severe rectal conditions such as cancer or severe inflammatory bowel disease (IBD). The surgery typically involves removing the lower portion of the colon, the rectum, and the anus along with the surrounding lymph nodes.

APR surgery is a complex and highly specialized procedure that requires expertise and experience in colorectal surgery. The decision to perform APR surgery is made after careful consultation with the patient, taking into account the stage and location of the rectal cancer, as well as the patient's overall health and preferences.

When is APR Surgery Necessary?

APR surgery is primarily indicated in cases where the rectal cancer is located low in the rectum and cannot be removed by less invasive techniques such as local excision or transanal endoscopic microsurgery (TEM). APR surgery is also considered when the cancer has spread to the surrounding lymph nodes or has invaded nearby structures, making it necessary to remove a wider margin of tissue to ensure complete tumor removal.

In some cases, APR surgery may also be performed for severe IBD that has not responded to other treatments, such as ulcerative colitis or Crohn's disease. The decision to perform APR surgery for IBD is made on a case-by-case basis, considering the extent and severity of the disease, the patient's symptoms, and their quality of life.

What are the Risks and Complications of APR Surgery?

APR surgery is a major surgical procedure with potential risks and complications, including:

• Bleeding
• Infection
• Damage to nearby organs, such as the bladder or ureters
• Pelvic nerve damage, which can lead to urinary or sexual dysfunction
• Permanent colostomy

The risk of complications from APR surgery varies depending on the patient's age, overall health, and the extent of the surgery. It is important to discuss the potential risks and benefits of APR surgery with your doctor before making a decision.

What is the Recovery Process After APR Surgery?

After APR surgery, patients typically stay in the hospital for 5-7 days for monitoring and recovery. During this time, you will receive pain medication, antibiotics, and other medications to prevent complications.

You will also need to follow a strict diet and gradually increase your activity level as you recover. Most patients are able to return to work or other normal activities within 6-8 weeks after surgery. However, it is important to listen to your body and rest when needed.

Regular follow-up appointments with your doctor are essential after APR surgery to monitor your recovery and check for any signs of recurrence or complications.

What are the Long-Term Outcomes of APR Surgery?

The long-term outcomes of APR surgery depend on the stage and location of the rectal cancer, as well as the patient's overall health. In general, patients who undergo APR surgery for rectal cancer have a good prognosis with a high chance of cure.

However, APR surgery can have a significant impact on a patient's quality of life. The permanent colostomy can lead to changes in bowel habits and social stigma. Pelvic nerve damage can also lead to urinary or sexual dysfunction.

It is important to discuss the potential long-term outcomes of APR surgery with your doctor before making a decision. Your doctor can help you understand the risks and benefits and develop a treatment plan that is right for you.