What is Intersphincteric resection?
introduced intersphincteric resection (ISR) followed by handâsewn CAA as an anal preservation procedure for very low rectal cancer closer to the anus. 14. ISR is the ultimate anal preservation surgery by both abdominal and anal approaches which consists of TME and excision of the internal anal sphincter.
What is APR medical term?
An abdominal perineal resection (APR) includes the resection of the sigmoid colon, rectum, and anus (figure 1) and the construction of a permanent end colostomy.
What is an Ischiorectal abscess?
Ischiorectal abscesses are the next most common type. These abscesses form when suppuration transverses the external anal sphincter into the ischiorectal space. An ischiorectal abscess may traverse the deep postanal space into the contralateral side, forming a so-called horseshoe abscess.
When is APR done?
An abdominoperineal resection (APR) is a surgery in which the anus, rectum and sigmoid colon are removed. This procedure is most often used to treat rectal cancers located very low in the rectum. Often this surgery occurs after you have completed radiation and/or chemotherapy treatments.
Why anterior resection is called?
Other terms used include low anterior resection (LAR), which classically refers to removal of the sigmoid colon and upper rectum and derives its name from the fact that the dissection is below the anterior reflection of the peritoneal lining.
What is the purpose of a lower anterior resection?
Low anterior resection (LAR) LAR is a surgery that’s done to treat rectal cancer. During LAR surgery, the part of your rectum with the cancer will be removed.
How is APR surgery done?
Preparing the anus for removal: Your surgeon then operates on the area between the legs (perineal region) to remove the anus. The anus, rectum, and sigmoid colon are removed from the body. The skin is sewn closed where the anus used to be located.
What causes Intersphincteric abscess?
Small glands just inside the anus are part of normal anatomy. If the glands in the anus become clogged, this may result in an infection. When the infection is serious, this often leads to an abscess. Bacteria, feces, or foreign matter can also clog the anal glands and cause an abscess to form.
How do you drain an Intersphincteric abscess?
To drain an intersphincteric abscess, a transverse incision is made in the anal canal below the dentate line posteriorly. The intersphincteric space is identified, and the plane between the internal and external sphincters is exposed.
What is APR procedure?
An abdominal perineal resection (APR) is a surgical procedure that removes the rectum and anus (perineal component) and creates an end colostomy (abdominal component). An APR is primarily used to resect a very low rectal cancer or anal cancer.
What are Lars?
Low anterior resection (LAR) syndrome (LARS) specifically refers to the bowel dysfunction following rectal cancer resection5.
What is difference between perirectal and perianal?
A pelvic CT with IV contrast can be used to differentiate between a perianal abscess, which is located beneath the skin of the anal canal and does not transverse the external sphincter, and a perirectal abscess, which is located beyond the external anal sphincter.
What is intersphincteric resection?
Intersphincteric resection (ISR) is an ideal technique that preserves the anus, regardless of whether the internal anal sphincter is removed. However, it is difficult to dissect the anterior wall of the rectum from the adjacent organs.
What are the goals of sphincter-preserving surgery (ISR)?
An important goal of sphincter-preserving surgery is to reach acceptable quality of life levels by preserving fecal continence. The main concern of the ISR technique is functional outcome. Physiologic studies have shown that anal resting pressure is due to the IAS for 55%, the hemorrhoidal plexus for 15%, and to the EAS for 30% [ 24
Is intersphincteric resection an alternative to abdominoperineal resection for low rectal cancer?
In recent years, intersphincteric resection for low rectal cancer has been offered and performed in patients as an alternative to abdominoperineal resection. An overview of this procedure, including indications, oncological and functional results based on current literature, is presented herein.
What is the principle of laparoscopic sphincter dissection?
The principle of the technique is based on the dissection of the anatomical plane between the internal sphincter. The surgical procedure is initiated by the abdominal approach, either laparocopicaly or open, performing the high ligation of the inferior mesenteric vessels and mobilization of the splenic flexure.