Lower anterior resection
| Lower anterior resection |
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A lower anterior resection, formally known as anterior resection of the rectum and anterior excision of the rectum or simply anterior resection (less precise), is a common surgery for rectal cancer and occasionally is performed to remove a diseased or ruptured portion of the intestine in cases of diverticulitis. It is commonly abbreviated as LAR.
LARs are for cancer in the proximal (upper) two-thirds of the rectum which lends itself well to resection while leaving the rectal sphincter intact.[1]
Relation to abdominoperineal resection
LARs, generally, give a better quality of life than abdominoperineal 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.
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 (stool and gases), fecal urgency, frequent bowel movements and bowel fragmentation. These symptoms have a major impact on the quality of life of patients and several studies have tried to establish the prevalence and severity of this syndrome as well as its correlation with epidemiological factors. So far, neoadjuvant therapy for rectal cancer, total versus partial mesorectal excision, patient age <64, anastomotic leak and female sex have been identified as predisposing factors for severity and duration of LARS symptoms. Presence of ileostomy or time to ileostomy closure is not associated with the development of this syndrome.[4]
References
- ^ "Detailed Guide: Colon and Rectum Cancer". American Cancer Society. Retrieved February 5, 2008.
- ^ McLeod RS (2001). "Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer". Ann. Surg. 233 (2): 157–8. doi:10.1097/00000658-200102000-00002. PMC 1421195. PMID 11176119.
- ^ Grumann MM, Noack EM, Hoffmann IA, Schlag PM (2001). "Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer". Ann. Surg. 233 (2): 149–56. doi:10.1097/00000658-200102000-00001. PMC 1421194. PMID 11176118.
- ^ Jiménez-Rodríguez, Rosa María Segura-Sampedro, Juan Jose José Rivero Belenchón, Inés Díaz-Pavón, José Manuel García-Cabrera, Ana María Vázquez Monchul, Jorge Manuel Padillo Ruiz, Javier de la Portilla de Juan, Fernando. "Is time to ileostomy closure a factor determining the presence of LARS?". Colorectal Disease.
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