Anterior resection

This is an operation to remove part of the rectum and part of the left side of the large bowel. It is most commonly performed for bowel cancer.

It can be performed "open" with an incision in the abdominal wall or laparoscopically, commonly called "keyhole surgery".

After the segment of bowel is removed, along with its blood supply, the two ends of bowel are joined together (anastomosed) with stitches or stapling devices. This requires the anal canal to be preserved, and the bowel upstream to be able to be brought down to join the rectum or anus without compromising the bowels blood supply.

It is uncommon to require a bag or stoma in association with a high anterior resection, which involves removing the upper part of the rectum, and if it is required it is usually associated with some emergency situations and when the patient is very unhealthy.

It is more common to require a bag or stoma in association with a low or very low anterior resection, which involves removing most or all of the rectum. The bag or stoma is usually a loop ileostomy to divert faecal matter from the downstream bowel join.

If the anus has to be cut out because of the rectal tumours position, or a bowel join cannot be performed, a left sided end colostomy is usually created.

The risks associated with an anterior resection can be related but not limited to the wounds (wound infection, hernia), the bowel join (leakage, bleeding), and to the patient's heart (arrhythmia), lungs (infection), kidneys and urinary system and the venous system (deep vein thrombosis, pulmonary emboli).

Pain relief is well organised after the procedure by the hospitals anaesthetic department. Fluids and return to a normal diet are determined by your doctors' usual protocol and your individual circumstances.

It is best to discuss more details regarding your specific case with your doctor.

Reviewed 2017