TY - CHAP M1 - Book, Section TI - Abdominoperineal Excision of the Rectum A1 - Garcia-Aguilar, Julio A2 - Bristow, Robert E. A2 - Chi, Dennis S. PY - 2015 T2 - Radical and Reconstructive Gynecologic Cancer Surgery 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - obgyn.mhmedical.com/content.aspx?aid=1179985381 ER -