Abdominoperineal resection - Revision history

Kodyarmann at 05:43, 18 April 2026

2026-04-18T05:43:54Z

← Older revision		Revision as of 22:43, 17 April 2026
Line 40:		Line 40:
	\|-		\|-
	\|Neurologic		\|Neurologic
	\|		\|Consider epidural analgesia vs regional anesthesia for open approach
	* Consider epidural analgesia vs regional anesthesia for open approach
	\|-		\|-
	\|Cardiovascular		\|Cardiovascular
	\|		\|Careful attention to fluid management with open abdomen especially if patient received a bowel prep
	* Careful attention to fluid management with open abdomen especially if patient received a bowel prep
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
	\|		\|Assess for nausea and vomiting prior to induction
	* Assess for nausea and vomiting prior to induction
	\|-		\|-
	\|Hematologic		\|Hematologic
	\|		\|Type and screen
	* Type and screen
	* Potential for anemia of chronic disease		Potential for anemia of chronic disease
	* Obtain platelet count if planning on epidural
			Obtain platelet count if planning on epidural
			\|-
			\|Renal
			\|Consider prerenal injury from bowel prep especially if patient already has decreased PO intake in the setting of malignancy
	\|}		\|}

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	* Fluid warmer and Bair hugger		* Fluid warmer and Bair hugger
	* OG vs NG tube		* OG vs NG tube

			=== Patient preparation and premedication ===

			* Patients often have bowel prep
			** Patients typically dehydrated and may have electrolyte abnormalities
			* Consider pre-loading patients that are hypovolemic
			* Presurgical ERAS protocol

	=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===		=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
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	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	* Standard maintenance with either inhalational agent or TIVA. Consider short acting opioids to minimize the risk of postoperative ileus.		* Standard maintenance with either inhalational agent or TIVA
			*Consider short acting opioids to minimize the risk of postoperative ileus if no epidural was placed
			*Operative time will be prolonged if plastic surgery is required for a perineal flap

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
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	* Epidural analgesia if placed preoperatively		* Epidural analgesia if placed preoperatively
	*		* Consider non-opiate adjuncts
			*Multi-modal pain management
			*May have APS consult if uncontrolled pain or ERAS protocol depending on surgeon

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

			* Hemorrhage
			* Anastomotic leak leading to sepsis/septic shock
			* High risk for VTE
			* Compartment syndrome if legs remain down for a prolonged time with significant fluid/blood resuscitation
			* PONV

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
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	\|+		\|+
	!		!
	!~~Variant 1~~		!Open
	!~~Variant 2~~		!Laparoscopic/Robotic
	\|-		\|-
	\|Unique considerations		\|Unique considerations
	\|		\|More insensible losses/fluid shifts
	\|		More painful
	\|-
	~~\|Indications~~
	\|
	\|		\|
	\|-		\|-
	\|Position		\|Position
	\|		\|Supine, lithotomy, possible prone for pelvic portion
	\|		\|Supine, lithotomy, possible prone for pelvic portion
	\|-		\|-
	\|Surgical time		\|Surgical time
	\|		\|6-12 hours
	\|		\|6-12 hours
	\|-		\|-
	\|EBL		\|EBL
	\|		\|100-500ml
	\|		\|<100ml
	\|-		\|-
	\|Postoperative disposition		\|Postoperative disposition
	\|		\|PACU
	\|		\|PACU
	\|-		\|-
	\|Pain management		\|Pain management
	\|		\|Multimodal analgesia, epidural anesthesia, PCA, regional
	\|		\|Multimodal analgesia, opioids, regional
	\|-		\|-
	\|Potential complications		\|Potential complications
	\|		\|Hemorrhage, VTE, hypovolemia, PONV
	\|		\|Possible difficulty ventilating during insufflation
	\|}		\|}

Kodyarmann at 02:32, 18 April 2026

2026-04-18T02:32:55Z

Show changes

Kodyarmann: Article creation

2026-04-18T01:59:50Z

Article creation

New page

{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary here.

== Overview ==

=== Indications ===

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Indications
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]