Keyhole surgery
Laparoscopic anterior resection
Keyhole removal of the upper or middle rectum for cancer, with the bowel rejoined — preserving the anal sphincter, so no permanent stoma is needed.
In plain language
What this operation is
An anterior resection removes the part of the rectum containing the tumour, along with the fatty tissue and lymph nodes surrounding it, and joins the bowel back to the remaining rectum or anal canal.
The important point for most patients is what it preserves: the anal sphincter. That is the difference between this operation and an abdominoperineal resection, which removes the anus and requires a permanent colostomy.
Whether sphincter preservation is possible depends chiefly on how close the tumour is to the anus.
Who it is for
When this operation is advised
- Cancer of the upper or middle rectum
- A tumour far enough from the anal sphincter for a safe join to be made
- Some cases after chemotherapy or radiotherapy has shrunk the tumour
And when it is not. Where the tumour involves or sits very close to the sphincter, an anterior resection is not safe and an abdominoperineal resection is the correct operation.
How it works
From assessment to follow-up
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01
Staging
Colonoscopy with biopsy, MRI of the rectum and CT. The MRI in particular decides whether the sphincter can be preserved.
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02
Treatment sequence
For some rectal cancers, chemotherapy or radiotherapy comes before surgery. That is decided from the staging.
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03
The operation
Through small ports where suitable. The rectum and surrounding tissue are removed and the bowel joined.
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04
Protecting the join
A temporary stoma is often created to protect the join while it heals, and reversed at a later operation.
Afterwards
What recovery involves
Recovery differs between patients. What follows is what usually happens — your own timeframe is given at discharge, based on the operation you actually had.
- This is a larger operation than a colectomy and the hospital stay reflects that.
- Where a temporary stoma is made, guidance on managing it is given before discharge.
- Bowel function after the rectum is shortened commonly takes months to settle into a pattern.
- Follow-up is ongoing, including the pathology result and a plan for surveillance.
When to go to hospital instead
Fever, severe abdominal pain or a swollen abdomen after surgery needs urgent hospital assessment.
Common questions
Questions patients ask
Anything not covered here can be answered at the consultation.
01 Will I need a permanent stoma?
No — sphincter preservation is the purpose of this operation. A temporary stoma is often used to protect the join while it heals, and it is reversed at a later operation. A permanent colostomy is required for abdominoperineal resection, which is a different procedure.
Stoma02 What decides whether my sphincter can be preserved?
Chiefly how close the tumour sits to the anal sphincter, which is assessed on MRI. Response to chemotherapy or radiotherapy given beforehand can also affect it.
Sphincter03 Will my bowel habit be normal afterwards?
It commonly changes — more frequent or more urgent motions are usual at first, because the rectum’s reservoir function is reduced. It usually settles over months, and there is guidance and support for that period.
Bowel functionNext step
Bring your reports to a consultation
Often one visit is enough to know whether an operation is needed at all.