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Abdominoperineal Resection for Rectal Cancer in the Twenty-First Century: Indications, Techniques, and Outcomes
Alexander T Hawkins1,2, Katherine Albutt3, Paul E Wise4
1Department of Surgery, Section of Colon and Rectal Surgery, Massachusetts General Hospital, Boston, MA, USA. alexander.hawkins@vanderbilt.edu.
Background:
Management of low rectal cancer continues to be a challenge, and decision making regarding the need for an abdominoperineal resection (APR) in patients with low-lying tumors is complicated. Furthermore, choices need to be made regarding need for modification of the surgical approach based on tumor anatomy and patient goals.
Discussion:
In this article, we address patient selection, preoperative planning, and intraoperative technique required to perform the three types of abdominoperineal resections for rectal cancer: extrasphincteric, extralevator, and intersphincteric. Attention is paid not only to traditional oncologic outcomes such as recurrence and survival but also to patient-reported outcomes and quality of life.
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