Our Summary
This research paper discusses the history and development of a specific surgery for rectal cancer called abdominoperineal resection, or APR. This procedure is often associated with a surgeon named Miles who formalized it in 1908. However, this paper highlights that Japanese surgeons Ito and Torikata actually developed a similar technique in 1904. These surgeons introduced a two-team approach in 1906, which made the surgery safer and more efficient. The article explores the contributions of Ito and Torikata and their role in the development of this important surgical technique for treating rectal cancer.
FAQs
- What is the history of the abdominoperineal resection (APR) technique in rectal cancer surgery?
- Who are Ito and Torikata and what was their contribution to the development of APR?
- What is the two-team approach introduced by Ito and Torikata in 1906 and how does it improve surgical safety and efficiency?
Doctor’s Tip
A helpful tip a doctor might tell a patient about proctectomy is to follow their post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually increasing activity levels as advised. It is important to communicate any concerns or changes in symptoms to their healthcare team promptly to ensure a smooth recovery process.
Suitable For
Patients who are typically recommended for proctectomy include those with rectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), rectal prolapse, and certain types of rectal or anal fistulas. Other conditions that may warrant a proctectomy include severe hemorrhoids, rectal trauma, and certain types of pelvic floor dysfunction. Additionally, patients who have failed conservative treatments for their condition may also be candidates for proctectomy.
Timeline
Before proctectomy:
- Patient is diagnosed with rectal cancer through imaging tests and biopsies
- Patient undergoes preoperative preparation, which may include blood tests, imaging tests, and possibly chemotherapy or radiation therapy to shrink the tumor
- Patient meets with a surgeon to discuss the procedure, risks, and expected outcomes
- Patient undergoes proctectomy surgery, which involves removing the rectum and anus, and possibly part of the colon
- Patient recovers in the hospital for several days to weeks, depending on the extent of the surgery and any complications
After proctectomy:
- Patient may experience pain, discomfort, and difficulty with bowel movements in the immediate postoperative period
- Patient will gradually resume eating and drinking, and may be put on a temporary colostomy or ileostomy to allow the bowel to heal
- Patient will have follow-up appointments with their surgeon to monitor healing and discuss further treatment options, such as chemotherapy or radiation therapy
- Patient will undergo physical therapy to regain strength and function in the pelvic area
- Patient will eventually be able to resume normal activities and diet, but may need to make adjustments to their lifestyle to accommodate the changes in bowel function caused by the surgery.
What to Ask Your Doctor
- What are the reasons for recommending a proctectomy?
- What are the potential risks and complications associated with proctectomy?
- What is the recovery process like after proctectomy?
- What are the long-term implications of having a proctectomy?
- Are there any alternative treatment options to consider before proceeding with a proctectomy?
- How experienced are you in performing proctectomy procedures?
- What is the success rate for proctectomy in treating my specific condition?
- Will I need any additional treatments or follow-up care after the proctectomy?
- How can I prepare for the proctectomy procedure?
- Are there any lifestyle changes or precautions I should take after having a proctectomy?
Reference
Authors: Sakai Y. Journal: Surg Today. 2025 Jun;55(6):857-859. doi: 10.1007/s00595-024-02952-5. Epub 2024 Oct 28. PMID: 39467876