An abdomino-perineal resection is the
removal of the lowest part of the large bowel including the anus. The
anus is stitched closed. This operation is usually done to remove a
cancer of the lowest part of the bowel. A permanent colostomy (bag) is
also always made. Your doctor would have discussed the details with you.
You presented to your doctor with
symptoms relating to rectal disease, usually constipation and blood in
your stool. You were possibly also investigated with a colonoscopy
and/or a barium enema. Your doctor has decided that it is appropriate to
treat you by means of an abdomino-perineal resection as your cancer is
too low in your bowel to allow him, after removing the cancer, to join
your bowel ends together again.
You will need to have your large bowel cleansed before the
Your doctor will explain to you whether he wants this done at
home or whether he needs you to be admitted to hospital for bowel
preparation. This preparation is very important.
The optimum site for your colostomy will be marked before the
operation. This is usually done by one of the stomatherapy sisters.
Make sure your doctor knows what medicines you take, especially
medicines which may affect blood clotting.
You must not eat or drink anything for 6 hours before the
You will be asleep for the operation.
The operation is usually done by 2 surgeons working together.
The operation usually takes 2 to 3 hours.
You will wake up in the recovery room or in the intensive care
You will have an infusion into your arm, neck or chest. You may
have a tube through your nose into your stomach. You will have a
catheter in your bladder. The anaesthetist may have decided to do an
epidural on you for pain control.
When you are well enough to leave the intensive care unit you
will be returned to your usual hospital bed.
At an appropriate time your stitches will be removed.
You will be instructed to what extent you are allowed to walk
You will be instructed regarding the care of your colostomy
You will be instructed regarding bathing and showering.
You will be instructed by your doctor regarding driving and
returning to work.
An abdomino-perineal resection is a major abdominal operation
and complications do occur. You must be aware of the following
The colostomy sometimes gives problems like necrosis or narrowing and
may need to be refashioned by means of another operation.
Wound infections of the abdominal or perineal wounds occur fairly
commonly. If this happens, your doctor will decide how best to manage it.
Intra-abdominal complications or infections can occur which may
necessitate a re-operation.
Chest infections are fairly common after this operation. This is
the reason that your doctor will probably order chest physiotherapy.
In a man, it is quite common for this operation to have an
adverse effect on your sexual activities
Deep vein thrombosis, pulmonary embolism and heart attacks are
possible after any major operation.