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Low Anterior Resection and Abdominoperineal Resection

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Illustrative Handbook of General Surgery

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Abstract

Low anterior resection (LAR) and abdominoperineal resection (APR) are the primary surgical interventions for rectal cancer. Proctectomy with an ultra-low or colo-anal anastomosis can also be performed as part of the surgical treatment for benign diseases, such as ulcerative colitis and familial adenomatous polyposis. The procedures are performed both open and laparoscopically, depending on various patient factors, disease pathophysiology, and surgeon preference. Robotic LAR or APR may also be performed with similar outcomes depending on surgeon experience.

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References

  1. Nash GM, Weiser MR, Guillem JG, Temple LK, Shia J, Gonen M, Wong WD, Paty PB. Long-term survival after transanal excision of T1 rectal cancer. Dis Colon Rectum. 2009;52(4):577–82.

    Article  PubMed  Google Scholar 

  2. Heidary B, Phang TP, Raval MJ, Brown CJ. Transanal endoscopic microsurgery: a review. Can J Surg. 2014;57(2):127–38.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery–the clue to pelvic recurrence? Br J Surg. 1982;69(10):613–6.

    Article  CAS  PubMed  Google Scholar 

  4. Cecil TD, Sexton R, Moran BJ, Heald RJ. Total mesorectal excision results in low recurrence rates in lymph node-positive rectal cancer. Dis Colon Rectum. 2004;47(7):1145–9.

    Article  PubMed  Google Scholar 

  5. Bernstein TE, Endreseth BH, Romundstad P, Wibe A, Norwegian Colorectal Cancer Group. Circumferential resection margin as a prognostic factor in rectal cancer. Br J Surg. 2009;96:1348–57.

    Article  CAS  PubMed  Google Scholar 

  6. Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R, German Rectal Cancer Study Group. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731–40.

    Article  CAS  PubMed  Google Scholar 

  7. DeCaluwe L, Van Nieuwenhove Y, Ceelen WP. Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer. Cochrane Database Syst Rev. 2013;2, CD006041.

    Google Scholar 

  8. Janjan NA, Crane C, Feig BW, Cleary K, Dubrow R, Curley S, Vauthey JN, Lynch P, Ellis LM, Wolff R, Lenzi R, Abbruzzese J, Pazdur R, Hoff PM, Allen P, Brown T, Skibber J. Improved overall survival among responders to preoperative chemoradiation for locally advanced rectal cancer. Am J Clin Oncol. 2001;24(2):107–12.

    Article  CAS  PubMed  Google Scholar 

  9. Maas M, Beets-Tan RG, Lambregts DM, Lammering G, Nelemans PJ, Engelen SM, van Dam RM, Jansen RL, Sosef M, Leijtens JW, Hulsewe KW, Buijsen J, Beets GL. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol. 2011;29(35):4633–40.

    Article  PubMed  Google Scholar 

  10. Contant CM, Hop WC, van’t Sant HP, Oostvogel HJ, Smeets HJ, Stassen LP, Neijenhuis PA, Idenburg FJ, Dijkhuis CM, Heres P, Vantets WF, Gerritsen JJ, Weidema WF. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial. Lancet 2007;22:370(9605):2112–7.

    Google Scholar 

  11. Fry DE. Colon preparation and surgical site infection. Am J Surg. 2011;202:225–32.

    Article  PubMed  Google Scholar 

  12. Guenaga KF, Matos D, Wille-Jorgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2011;9:1–56.

    Google Scholar 

  13. The Joint Commission. Surgical Care Improvement Project. http://www.jointcommission.org/surgical_care_improvement_project/. Accessed 16 Oct 2014.

  14. Nelson RL, Gladman E, Barbateskovic M. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2014;5:1–262.

    Google Scholar 

  15. Moore HG, Riedel E, Minsky BD, Saitz L, Paty P, Wong D, Cohen AM, Guillem JG. Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol. 2003;10(1):80–5.

    Article  PubMed  Google Scholar 

  16. Hallbook O, Pahlman L, Krog M, Wexner SD, Sjodahl R. Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection. Ann Surg. 1996;224(1):58–65.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Vennix S, Pelzers L, Bouvy N, Beets GL, Pierie JP, Wiggers T, Breukink S. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2014;4:CD005200.

    PubMed  Google Scholar 

  18. Mak TW, Lee JF, Futaba K, Hon SS, Ngo DK, Ng SS. Robotic surgery for rectal cancer: a systematic review of current practice. World J Gastrointest Oncol. 2014;6(6):184–93.

    PubMed Central  PubMed  Google Scholar 

  19. Kang CY, Carmichael JC, Friesen J, Stamos MJ, Mills S, Pigazzi A. Robotic-assisted extralevator abdominoperineal resection in the lithotomy position: technique and early outcomes. Am Surg. 2012;78(10):1033–7.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Wisconsin, Madison, WI, USA

    Laura E. Fischer MD, MS

  2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, K4/734 CSC 600 Highland Avenue, Madison, WI, 53792, USA

    Charles P. Heise MD, FACS

Authors
  1. Laura E. Fischer MD, MS
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  2. Charles P. Heise MD, FACS
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Corresponding author

Correspondence to Charles P. Heise MD, FACS .

Editor information

Editors and Affiliations

  1. University of Wisconsin, Madison, Wisconsin, USA

    Herbert Chen

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© 2016 Springer International Publishing Switzerland

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Fischer, L.E., Heise, C.P. (2016). Low Anterior Resection and Abdominoperineal Resection. In: Chen, H. (eds) Illustrative Handbook of General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-24557-7_24

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  • DOI: https://doi.org/10.1007/978-3-319-24557-7_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24555-3

  • Online ISBN: 978-3-319-24557-7

  • eBook Packages: MedicineMedicine (R0)

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