What is an Anterior Resection?

An anterior resection is a surgical procedure used to treat people with rectal cancer in the upper section of the rectum. This surgery is an invasive bowel surgery, but is considered less invasive than some other treatment options like abdominoperineal resections, and may result in a better outcome for the patient. The procedure can be performed by a general surgeon, oncological surgeon, or gastrointestinal expert, and is done under general anesthesia. Recovery times vary, and patients will likely spend a few days recovering in the hospital after the surgery.

When a patient is diagnosed with rectal cancer, early diagnosis includes collection of samples for biopsy, along with medical imaging of the rectum to collect as much information as possible about the cancer. This is used to develop an appropriate treatment plan. When surgery to remove the cancer is recommended, the surgeon will consider an anterior resection if it is an available option.

In an anterior resection, an incision is made in the abdomen to allow a surgeon to cut out the cancerous section of the rectum. The surgeon typically takes clean margins around the edge of the tissue to ensure that all of the cancerous cells are removed. The two segments of bowel created by the cut are sewn together in an anastomosis. The big advantage to an anterior resection is that the anus is left intact, allowing patients to defecate normally.

Typically, a temporary loop ileostomy needs to be performed to allow the colon to heal. In this procedure, a loop of bowel is used to temporarily drain feces through the patient's abdomen and into a collection pouch. Once the colon is healed after surgery, another procedure can be performed to reverse the ileostomy and restore normal bowel function to the patient. For patients concerned about having to wear a bag to collect feces, the possibility of ileostomy reversal and regular defecation can be a relief.

After an anterior resection, the patient may need to eat a special diet during healing to avoid stressing the bowel. In the hospital, the surgical site will be inspected regularly for signs of inflammation and infection so care providers can act quickly if complications develop. Once the patient is making satisfactory progress, it is possible to discharge the patient to recover at home. If chemotherapy or radiation are recommended, the patient should be able to receive these cancer treatments on an outpatient basis, reporting to a clinic or hospital for treatment as needed.