| Lower anterior resection | |
|---|---|
| Other names | Anterior resection of the rectum and colon |
| Specialty | General surgery |
Alower anterior resection, formally known asanterior resection of the rectum and colon andanterior excision of the rectum or simplyanterior resection (less precise), is a common surgery forrectal cancer and occasionally is performed to remove a diseased or ruptured portion of the intestine in cases ofdiverticulitis. It is commonlyabbreviated asLAR.[citation needed]
LARs are for cancer in theproximal (upper) two-thirds of the rectum which lends itself well to resection while leaving the rectal sphincter intact.[1]
LARs, generally, give a betterquality of life thanabdominoperineal resections (APRs).[2][3] Thus, LARs are generally the preferred treatment for rectal cancer insofar as this is surgically feasible. APRs lead to a permanent colostomy and do not spare the sphincters.[citation needed]
Low anterior resection syndrome (LARS) comprises a collection of symptoms mainly affecting patients after surgery for rectal cancer characterized byfecal incontinence (stool and gases), fecal urgency, frequent bowel movements and bowel fragmentation, while some patients only experience constipation and afeeling of incomplete bowel emptying.[4][5][6] The cause is unclear, and has been thought to be due to nerve damage, or possibly due to loss of the rectoanal inhibitory reflex.[5]
Many of the symptoms of LAR syndrome improve over a period of many months.[7] The nerves that control the natural contractions of the colon and rectum run along the colon and can be damaged or cut during the surgery.[citation needed] After such damage, the nerves can regrow, but only slowly.
These symptoms improve with time and most patients can enjoy almost normal daily life by the sixth postoperative month.