Abdominoperineal Resection
Combined abdominal and perineal excision of the rectum and anus for low rectal cancer — permanent end colostomy.
What is Abdominoperineal Resection?
Abdominoperineal resection (APR) is a combined abdominal and perineal operation for low rectal and anal canal cancers in which the rectum, anus, and sphincter complex are excised en bloc with formation of a permanent end colostomy. It is the procedure of choice when the tumour involves the sphincter or levator muscles.
Dr. Tagore Mohan Grandhi performs APR using a combined laparoscopic abdominal and perineal approach. Modern extra-levator APR (ELAPE) techniques improve specimen quality and reduce the risk of intraoperative perforation in selected cases.
Indicated for low rectal cancers and anal canal tumours in which the sphincter complex is involved or adequate distal clearance cannot be achieved while preserving continence.
How the Procedure Works
Patient Positioning
Patient placed in modified Lloyd-Davies position under general anaesthesia, allowing simultaneous abdominal and perineal access.
Abdominal Phase
Sigmoid colon and rectum mobilised laparoscopically. Inferior mesenteric vessels divided. Total mesorectal excision performed. Permanent end colostomy formed in the left iliac fossa.
Perineal Phase
Circumferential perineal incision made around the anus. Dissection proceeds outside the external sphincter through the ischiorectal fat. ELAPE technique used for selected bulky tumours.
Specimen Removal and Closure
Intact specimen — rectum, sphincter complex, and mesorectum — removed via the perineum. Perineal wound closed primarily or with biological mesh repair.
Recovery
Enhanced recovery protocol commenced. Stoma care education provided pre- and post-operatively. Oncological follow-up as per multidisciplinary plan.
Outcomes
Who Needs This Treatment?
- →Achieves complete oncological clearance where sphincter preservation would compromise margins
- →ELAPE technique improves specimen quality and reduces perforation risk in selected cases
- →Laparoscopic abdominal phase minimises wound morbidity and accelerates recovery
- →Multidisciplinary stoma care support optimises adjustment and quality of life
For patients with low rectal cancer where sphincter preservation is not oncologically appropriate, abdominoperineal resection provides the best chance of cure. Modern ELAPE techniques and comprehensive stoma support allow patients to return to a full and active life.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Abdominoperineal Resection (APR) Cost for Rectal Cancer in Hyderabad
The cost of Abdominoperineal Resection (APR) for Rectal Cancer in Hyderabad depends on factors such as tumour location, involvement of surrounding structures, surgical complexity, hospital stay, and post-operative care.
For patients with very low rectal tumours requiring removal of the anus and creation of a permanent colostomy, the approximate cost of APR ranges between ₹3,00,000 and ₹5,50,000.
| Procedure | Approximate Cost Range |
|---|---|
| Abdominoperineal Resection (APR) | ₹3,00,000 – ₹5,50,000 |
The final cost may vary depending on your individual condition, surgical findings, hospital care, and additional oncology treatments.
Factors That Influence APR Cost
The overall cost may depend on:
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Tumour location and extent: Very low rectal tumours and involvement of nearby structures may require more complex surgical planning.
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Pre-operative evaluation: Cancer staging scans, biopsy reports, blood tests, and medical assessments may influence the overall cost.
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Surgical complexity: The procedure involves rectal removal and permanent colostomy creation, which may affect hospital stay and recovery requirements.
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Post-operative care: Stoma management, dietary support, medications, and follow-up consultations may contribute to overall treatment costs.
Is APR Covered by Insurance?
Abdominoperineal Resection for medically necessary rectal cancer treatment may be covered by health insurance. Coverage depends on your insurance policy, insurer approval, and documentation requirements.
Our insurance support team can assist with checking coverage eligibility, required documentation, and cashless approval procedures.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Tagore Grandhi
Orthopaedic & Joint Replacement Surgeon
During consultation, Dr. Tagore Mohan Grandhi, Bariatric & GI Surgeon at Lux Hospitals, will assess your cancer stage, reports, and overall health to determine the most appropriate treatment approach. He will explain the procedure, recovery process, permanent stoma care requirements, and provide a personalised cost estimate.
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