What is an abdominoperineal (AP) resection?

Dr. James C. Rex, MD
Colorectal Surgeon

When rectal cancer actually involves the sphincter muscle of the rectum, removal of the tumor for cure involves removal of the muscle. Unfortunately without muscle the rectum cannot control the stool, leading to incontinence and subsequent very poor quality of life. In this situation, diverting the stool to a permanent colostomy on the abdominal wall results in a superior quality of life.  As colon and rectal surgeons we use our expertise to try and save the rectal muscle when possible and avoid a permanent colostomy.

This operation is more involved than a low anterior resection. It can be used to treat some stage I cancers and many stage II or III rectal cancers in the lower third of the rectum (the part nearest to the anus), especially if the cancer is growing into the sphincter muscle (the muscle that keeps the anus closed and prevents stool leakage).

Here, the surgeon makes one incision in the abdomen, and another in the perineal area around the anus. This incision allows the surgeon to remove the anus and the tissues surrounding it, including the sphincter muscle. Because the anus is removed, you will need a permanent colostomy to allow stool a path out of the body.

This operation requires general anesthesia (where you are asleep). As with a low anterior resection or a colo-anal anastomosis, the usual hospital stay for an AP resection is 4 to 7 days, depending on your overall health. Recovery time at home may be 3 to 6 weeks.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.