-
24/7 available services
-
Sphincter-Saving Rectal Cancer Surgery by Dr. Ashok Kumar, FASCRS
Call 05226664444Book AppointmentLAR is surgical removal of tumor-bearing rectum while preserving anal sphincter and bowel continuity. Standard procedure for mid and upper rectal cancers. Maintains normal bowel function in most patients. Requires complete mesorectal excision (TME) for optimal oncological outcomes.
Removes rectum with surrounding mesorectal tissue as oncological unit. Preserves autonomic nerves for sexual and urinary function. Creates anastomosis between proximal colon and distal rectum.
Laparoscopic approach preferred when feasible with equivalent oncological outcomes and better recovery.
Most patients achieve acceptable bowel function. Initially 4-6 bowel movements daily, improving to 2-3 over 3-6 months. 90% continence at 6-12 months post-op. Quality of life excellent in majority.
Local recurrence <5% with TME. Overall survival rates: Stage I 85-90%, Stage II 70-75%, Stage III 45-65%. Complications <5% with experienced surgeon.
Accurate estimate can be obtained from hospital while visiting the doctor.
Low anterior resection (LAR) is an operation to remove the part of the rectum that contains a tumour, together with the surrounding fatty tissue and lymph nodes (total mesorectal excision). The colon is then joined to the remaining rectum or the top of the anal canal, so that the anal sphincter is preserved and bowel movements continue through the anus.
An MRI of the pelvis and a CT scan are used to stage rectal cancer. Many patients receive radiotherapy and/or chemotherapy before surgery to shrink the tumour and reduce the chance of it coming back in the pelvis. Surgery is usually planned several weeks after this treatment.
LAR can be done by open, laparoscopic or robotic surgery. When the join is very low, a temporary loop ileostomy is often made to protect it while it heals. This is usually closed in a smaller operation after about two to three months, once tests confirm healing.
Because the storage space of the rectum is reduced, many people experience frequent or urgent bowel movements, clustering of stools or occasional leakage, known as low anterior resection syndrome. It usually improves over months. Diet changes, medicines and pelvic floor exercises can help.
Risks include leak from the join, bleeding, infection, urinary or sexual problems due to nerves in the pelvis, and changes in bowel function.
Typically five to eight days, depending on recovery.
Most patients having LAR keep their sphincter and the temporary stoma is closed later.
LAR keeps the anus and sphincter, while abdominoperineal resection removes them and creates a permanent colostomy.
Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.