Abdominoperineal Resection (Open, Laparoscopic)

This chapter describes the detailed steps for an abdominoperineal resection with irreversible closure of the anus and formation of a permanent end stoma. The technique may vary depending on whether it is done in oncological fashion for a distal rectal or anal malignancy or in a less extensive form for a number of benign conditions. The extent and approach (open versus minimally invasive) further depend on numerous factors, for example, the nature of the pathology, an elective versus nonelective scenario, sphincter function, and others. Multimodality treatment and possibly the presence of underlying risk constellations (hereditary cancer, inflammatory bowel disease) may affect the decision-making. This chapter includes details of indications, preoperative preparation, pitfalls and danger points, postoperative care, and complications. It also gives complete information on surgical strategy and technique.