RT Book, Section
A1 Garcia-Aguilar, Julio
A2 Bristow, Robert E.
A2 Chi, Dennis S.
SR Print(0)
ID 1115054904
T1 Abdominoperineal Excision of the Rectum
T2 Radical and Reconstructive Gynecologic Cancer Surgery
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071808095
LK obgyn.mhmedical.com/content.aspx?aid=1115054904
RD 2024/04/19
AB The  oncologic  removal  of  the  rectum  often  requires  both  an  abdominal  and  a  perineal  approach.  During  the  abdominal  portion  of  the  procedure,  the  superior  rectal  vessels  are  controlled,  the  rectum  and  mesorectum  dissected,  and  colostomy  created.  During  the  perineal  portion,  the  rectum  and  anus  are  detached  from  the  ischiorectal  fat,  the  levator  muscles,  and  whatever  portion  (if  any)  of  the  distal  portion  of  the  genitourinary  organs  not  planned  for  removal.  The  boundary  between  the  abdominal  and  perineal  parts  of  the  procedure  is  delineated  by  the  levator  muscles.  The  abdominoperineal  excision  (APE)  of  the  rectum  is  now  much  safer  than  when  it  was  first  introduced  more  than  a  century  ago.  However,  despite  the  advances  in  surgical  technique  and  perioperative  care,  it  remains  a  surgical  challenge  due  to  the  complex  anatomy  of  the  pelvis.