Abdominoperineal resection grossing
This protocol deals with abdominoperineal resection grossing.
Abdominoperineal resection, abbreviated APR, is also written as abdominal perineal resection.
LAR are the preferred surgery for rectal cancer, as individuals post-APR are left with a permanent stoma and expel fecal material into a bag.
- Abdominoperineal resection.
- Length: ___ cm.
- Circumference - proximal end: ___ cm.
- Circumference - distal end: ___ cm.
- Rectum length (distal margin to mesorectal reflection): ___ cm.
- Skin (anal): ___ cm.
Appearance - external:
- Completeness of mesorectal excision: [complete].
- Serosal aspect of bowel: [shiny].
- Perforation: [present/not present].
- Circumferential margin: [black].
- Serosal puckering: [blue].
- Dimensions (along axis, circumferential, depth): ___ x ___ x ___ cm.
- Distance to nearest mucosal margin: ___ cm, [distal] margin.
- Distance to circumferential margin: ___ cm.
- Circumferential location: [anterior/left/right/posterior/circumferential].
Representative sections are submitted as follows:
- Proximal margin. ‡
- Distal margin. ‡
- Tumour - deepest invasion.
- Additional sections of tumour (1 section/cm).
- All polyps (if less than 10).
- Normal appearing mucosa.
- Lymph nodes. †
- ‡ Usually submitted completely and en face; if the margin is close (<2 cm) on edge is typically preferred.
- † Recommended minimum number of lymph nodes is 12.