Lower anterior resection
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A lower anterior resection, formally known as anterior resection of the rectum and colon and anterior excision of the rectum or simply anterior resection (less precise), is a common surgery for
rectal cancer Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel ...
and occasionally is performed to remove a diseased or ruptured portion of the intestine in cases of
diverticulitis Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—Diverticulum, diverticula—that can develop in the wall of the large intestine. Symptoms typically include lo ...
. It is commonly
abbreviated An abbreviation () is a shortened form of a word or phrase, by any method including shortening, contraction, initialism (which includes acronym), or crasis. An abbreviation may be a shortened form of a word, usually ended with a trailing per ...
as LAR. LARs are for cancer in the
proximal Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
(upper) two-thirds of the rectum which lends itself well to resection while leaving the rectal sphincter intact.


Relation to abdominoperineal resection

LARs, generally, give a better
quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
than
abdominoperineal resection An abdominoperineal resection (abbreviated as AP resection, APR, or APER), formally known as an abdominoperineal resection of the rectum or an abdominoperineal excision of the rectum, is a surgical procedure performed to treat rectal cancer or an ...
s (APRs). 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.


Low anterior resection syndrome

Low anterior resection syndrome (LARS) comprises a collection of symptoms mainly affecting patients after surgery for rectal cancer characterized by
fecal incontinence Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents—including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom ...
(stool and gases), fecal urgency, frequent bowel movements and bowel fragmentation, while some patients only experience constipation and a feeling of incomplete bowel emptying. The cause is unclear, and has been thought to be due to nerve damage, or possibly due to loss of the rectoanal inhibitory reflex. Many of the symptoms of LAR syndrome improve over a period of many months. 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. After such damage, the nerves can regrow, but only slowly.


References


External links


LAR syndrome - patient education
{{Digestive system procedures General surgery Digestive system surgery