Abdomino-perineal resection is used to treat rectal carcinomas when the tumour mass is less than 10 cm from the anal verge. Clearance is not possible without removing the anus so that a permanent colostomy is unavoidable. The same resection is also used during panproctocolectomy for ulcerative colitis.
The rectum is mobilised within the pelvic musculature and the lower rectum and anus excised through a perineal incision. The anus is closed and the rectum removed. The subcutaneous fat and skin are closed and a drain left in the pelvis.
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