Rectal cancer

Understanding Rectal Cancer and Anterior Resection/APR Surgery

Introduction:

Rectal cancer is a type of cancer that develops in the rectum, which is the last part of the large intestine before it exits the body. It is a significant health concern globally, and its treatment often involves surgical procedures, with anterior resection (AR) and abdominoperineal resection (APR) being common approaches.

Rectal Cancer Overview:

Rectal cancer, like other types of colorectal cancer, usually starts as a polyp, a small growth on the inner lining of the rectum. Over time, some polyps can turn into cancer. Risk factors for rectal cancer include age, family history, inflammatory bowel disease, and certain genetic syndromes.

Anterior Resection (AR) Surgery:

1. Purpose:
AR surgery is a procedure used to treat rectal cancer located in the upper part of the rectum. The goal is to remove the cancerous part of the rectum and reconnect the remaining healthy portions.

2. Procedure:
– The patient is put under general anesthesia.
– The surgeon makes an incision in the abdomen to access the rectum.
– The cancerous portion of the rectum is removed.
– The healthy ends of the colon are then reconnected (anastomosis).
– In some cases, a temporary colostomy may be created to allow healing of the anastomosis.

3. Recovery:
– Recovery time varies, but most patients can return to normal activities within a few weeks.
– Rehabilitation and follow-up care are crucial to monitor for any complications.

4. Advantages:
– Preserving sphincter function, reducing the likelihood of a permanent colostomy.
– Less impact on bowel habits compared to APR.

Abdominoperineal Resection (APR) Surgery:

1. Purpose:
APR surgery is employed when rectal cancer is located very low in the rectum, close to the anus. This procedure involves the removal of the rectum and anus, creating a permanent colostomy.

2. Procedure:
– An incision is made in the abdomen, similar to AR.
– The rectum and anus are removed, and a colostomy is created by bringing the end of the colon to the surface of the abdomen.
– The patient will use a colostomy bag to collect waste.

3. Recovery:
– Recovery may take a bit longer than AR due to the creation of a colostomy.
– Adjusting to life with a colostomy bag requires education and support.

4. Indications:
– When the cancer is too low for preservation of sphincter function.
– In cases where the tumor involves the anal sphincter complex.

Conclusion:

The choice between AR and APR depends on various factors, including the location and stage of the cancer, the patient’s overall health, and individual preferences. Both surgeries aim to remove cancer while preserving quality of life. A multidisciplinary approach involving surgeons, oncologists, and support services is essential to provide comprehensive care for individuals dealing with rectal cancer. Regular follow-ups are crucial to monitor for any signs of recurrence and ensure the ongoing well-being of the patient.