This may sometimes be used to treat small, early stage cancers in the anal margin.
The operation only removes the area of the anus containing the cancer cells. The anal sphincter isn’t usually affected, so you should still be able to control your bowel in the normal way.
Your doctors may sometimes recommend that you have radiotherapy or chemoradiotherapy after you’ve had surgery.
If the cancer hasn’t gone completely after chemoradiotherapy, or if it comes back after treatment, you may be advised to have an abdomino-perineal (AP) excision. This involves removing the anus, the rectum and part of the large bowel (colon).
After an AP excision, you will usually have two wounds – an abdominal wound where the surgeon has removed the anus and rectum, and a wound where the anus has been surgically closed.
Sometimes the surgeon can do the operation using only four or five small cuts (about 1cm each) in your abdomen. They use specially designed instruments that can be put through these small cuts. This type of surgery is known as laparoscopic or keyhole surgery. There will still be a wound where the anus has been surgically closed.
Because the rectum and anus are removed, you will need a permanent colostomy. This involves diverting the open end of the bowel to the surface of the abdomen (tummy area), to allow bowel motions (stools) to be passed out of the body into a colostomy bag. The opening on the abdominal wall is called a stoma.
We have more information if you need a colostomy.