GENERAL INFORMATION
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.
DIAGNOSIS
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.
PRE-OPERATIVE PREPARATION
- You will need to have your large bowel cleansed before the operation.
- 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 stomal therapy 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 8 hours before the operation.
THE OPERATION
- You will be asleep for the operation.
- The operation usually takes 2 to 3 hours.
POST-OPERATIVE CARE
- You will wake up in the recovery room or in the intensive care unit.
- You will have an infusion into your arm or neck. 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/high care unit you will be returned to your usual hospital bed.
- At an appropriate time your stitches will be removed.
HOME CARE
- You will be instructed to what extent you are allowed to walk around.
- 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.
COMPLICATIONS
- An abdomino-perineal resection is a major abdominal operation and complications do occur. You must be aware of the following possible complications.
- 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.