Abdominoperineal extirpation of the rectum is a surgical procedure where the whole is removed from the rectum of the closing device and the distal part of the sigmoid colon. The procedure is performed in two accesses: perineal and abdominal. It has been used successfully for over 100 years for the treatment of cancer, which is located in the lower part of the rectum (less than 4 cm from the anus).

During surgery, the surgeon forms a permanent colostomy - part of the colon is displayed in the hole on the skin surface, which provides an output of food waste from the patient's body. The stools are collected in a special bag (Colostomy bags). Dimensions of the stoma (opening) generally range from 1 inch (2.54 cm) to about 1 ½ inches in diameter.

Surgical removal of intestinal tumors in Israel - from 15 000 $.

To minimize complications and maximize the effect of treatment the patient must be very careful approach to the choice of doctor and hospital where the operation will be carried out.

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Carrying abdominoperineal extirpation of the rectum in Israeli hospitals

Depending on the individual characteristics of the patient and the development of a malignant tumor, the operation for rectal cancer may be performed in two ways: conventional and laparoscopically, as well as different methods.

The most commonly used in Israel, radical surgery, the performance of which is produced in two stages (open abdominal and perineal access after) by a single surgeon or synchronous operation of the two teams. The patient takes a lithotomy position with giving the operating table tilt (by Trendelenburg). The patient's urinary bladder catheter to drain urine at the time of surgery.

I stage- abdominal

The patient is under general anesthesia. The surgeon makes an incision abdominal wall (laparotomy) and produces an audit organs for determining metastasis is performed further mobilization of the sigmoid colon and rectum selection. Surgeon crosses the sigmoid colon, and then forms a colostomy - shows stump ulcer in the left iliac region and sutured it to the parietal layer of the peritoneum. Further abdominal incision closed by suture.

II stage- crotch

Anus sutured purse string suture. At a distance of several centimeters from the anus surgeon makes an oval section, through which the removal and recovery of the rectum and the sigmoid colon portion. After the bleeding stopped, the wound is treated and sutured.

During laparoscopic abdominal-perineal rectum extirpation isolation and removal rectum and sigmoid carried through several (two to five) small incisions. With the help of a laparoscope equipped with a video camera and inserted into the peritoneal cavity, the physician receives the most accurate images of internal organs and can control the whole process of the operation. The cuts also insert special surgical instruments by means of which, and the procedure is performed.

Staying in the hospital after the laparoscopic procedure is 5 to 7 days. Upon completion of the transaction it is equipped with a special stoma bag, but the patient's digestive system is restored in just a few days.

Recovery after abdominoperineal extirpation of the rectum

Rehabilitation Patient is a lengthy process. Even after hospital discharge must pass a lot of time before the patient's body will be fully restored. The patient starts to feel normally only a few weeks later.

After the operation carried out intravenous drip, as well as the patient receives painkillers drugs. To prevent nausea or vomiting, it may be administered nasogastric tube, and to facilitate excretion of urine and measuring the amount thereof using a urinary catheter.

To discharge the patient receives the most accurate and detailed instructions on wound care, the future way of life and a new diet. Israeli doctors clinics also describe all sorts of risks that may be encountered people who have had surgery, and give advice on how to avoid them.

The possibility of complications after surgery

  1. pain;
  2. incision infection;
  3. appearance of thrombus;
  4. scarring;
  5. hernia;
  6. problems with urination;
  7. adhesions;
  8. sexual dysfunction (dry orgasm, retrograde ejaculation and impotence).

When resection of malignant tumor is removed portion adjacent healthy tissues, for this reason, oncological surgery is quite traumatic. Currently, if conducted in Israel, surgical trauma is reduced to a minimum thanks to precision diagnostic, modern surgical techniques, reconstructive surgery capabilities.

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