Low Anterior Resection (LAR)

Rectal cancer in the upper or middle sections is typically treated with a Low Anterior Resection (LAR). This approach ensures the tumour is excised while the patient’s sphincter muscles are preserved. After the diseased portion is gone, the surgeon reconnects the bowel to allow for normal, natural bowel movements post-recovery. 

LAR is a specialised procedure performed by colorectal surgeons using open, laparoscopic (keyhole), or robotic-assisted methods. The goal is to remove the cancer completely while preserving the patient’s natural digestive function. This approach offers a definitive treatment path with a focus on a high quality of life after the healing process is complete. It is a standard, effective choice for many patients facing this diagnosis. Let’s learn about this procedure in detail.

Low Anterior Resection (LAR) treats upper and middle rectal cancers. The surgery removes the tumour and lymph nodes for staging, then reattaches the colon to the lower rectum (anastomosis). A temporary stoma, an abdominal opening for a waste bag, is often created to allow the new connection to heal safely. This is usually reversed later. 

LAR is a sphincter-preserving surgery, meaning the anal muscles are saved. This allows many patients to maintain their natural bowel function after full recovery. It is an effective treatment that balances complete cancer removal with the goal of returning the patient to their normal routine and avoiding the need for a permanent external stoma bag.

Low Anterior Resection (LAR) is the standard surgical response when clinical imaging and biopsies confirm mid-to-upper rectal cancer. This procedure is designed to excise the tumour completely whilst preserving the patient’s continence. 

This surgery is often recommended when: 

• The cancer is in the middle or upper rectum.
• The tumour hasn't spread to nearby organs.
• We can safely keep your sphincter muscles.
• We need to remove the nearby lymph nodes.
• You are following a personalised cancer management plan.
• Complete removal gives you the best chance of recovery.

Your tissue goes to the lab afterwards to help us plan any next steps, like chemotherapy, if needed.

Not every patient with colorectal cancer requires an identical surgical plan. Doctors must weigh various clinical factors to determine if Low Anterior Resection (LAR) is the most appropriate treatment option. 

You might be a candidate for LAR if: 

• Your tumour is in the middle or top of the rectum.
• There is a likelihood of tumour removal with preservation of sphincter function.
• Tests show the cancer is only in the rectum or nearby glands.
• You are fit enough for a big operation.
• You have had any needed chemo first.
• We can safely join your bowel back up.

It is important to understand that while Low Anterior Resection (LAR) is effective, it must be matched to the right patient. Your consultant will conduct a thorough review of your medical history, scan results, and the tumour's characteristics to ensure a safe plan is in place. 

LAR is usually not recommended for patients who: 

• Have tumours too low for sphincter preservation.
• Suffer from extensive local cancer spread.
• Are unfit for major abdominal surgery.
• Have significant heart or lung disease.
• Present with widespread metastatic disease. 

In such cases, doctors will propose alternative surgical or medical interventions. These decisions are made to ensure that the treatment plan is both safe and as effective as possible for the patient’s unique clinical condition.

We provide a comprehensive briefing beforehand to ensure patients understand the gravity of the risks. Our team conducts a rigorous review of clinical histories and high-resolution diagnostic imaging, such as MRI. 

Before the procedure, patients must adhere to the following: 

• Strictly follow preoperative dietary instructions.
• Avoid all food and drink for several hours.
• Inform the doctor about any medications currently taken.
• Stop specific blood-thinning medicines if advised.
• Complete your recommended preoperative tests.

It is important to understand that a Low Anterior Resection is a significant operation performed under general anaesthesia. The surgeon will access the abdomen, using either traditional or minimally invasive methods, to excise the tumour and surrounding lymph nodes. Achieving a secure reconnection of the bowel is critical. In certain cases, the surgical team may decide that a temporary stoma is required to ensure the healing of the internal joint, which can be reversed in a follow-up procedure. Patients should be aware that the surgery is complex and typically requires several hours to complete safely.

After your surgery, you will be moved to a recovery area where our team will closely monitor your vital signs. The hospital stay typically lasts several days to rest. You may need fluids or nutrition through a drip until your bowel function returns to normal. 

Some temporary effects after surgery may include: 

• Abdominal discomfort or soreness
• Temporary changes in bowel habits
• Fatigue related to the surgery
• Reduced appetite during the early recovery period 

We will slowly reintroduce a normal diet and encourage you to walk as soon as possible. Your tissue is sent for analysis, which helps us decide on any further care.

While a Low Anterior Resection is a significant operation, please be reassured that your safety is our top priority. We use careful planning and constant monitoring to reduce the risk of any issues during your recovery. 

Possible complications may include: 

• Bleeding during or after surgery
• Infection at the surgical site
• Leakage from the reconnection site
• Temporary changes in bowel habits
• Blood clots in the legs or lungs
• Narrowing of the surgical connection 

Our team is always nearby to act quickly if needed.

Low Anterior Resection is an effective procedure that aims to clear the cancer whilst protecting your quality of life. 

The procedure may help doctors to: 

• Remove rectal tumours completely
• Preserve the anal sphincter and natural bowel function
• Remove lymph nodes for accurate cancer staging
• Improve the chances of long-term disease control
• Reduce the need for permanent colostomy

 With modern care, you can expect a steady recovery ahead.

Low Anterior Resection is performed at Gleneagles Hospitals by experienced colorectal surgeons. We offer a full range of services for patients undergoing gastrointestinal cancer treatment. 

Facilities available at the hospital include: 

• Modern operating theatres
• Minimally invasive surgical techniques
• Continuous monitoring during surgery and recovery
• Multidisciplinary cancer care teams
• On-site pathology services
• Postoperative care and rehabilitation support 

Patients receive comprehensive guidance before surgery and diligent monitoring throughout their recovery.

Low Anterior Resection is used to treat rectal cancer by removing the tumour and nearby lymph nodes while aiming to preserve the anal sphincter. After removal, your bowel is reconnected to maintain normal function. The tissue is then tested to help plan your further care. At Gleneagles Hospitals, we recommend this surgery when it is the best path for your long-term health.