Surgical procedure focused on the lower abdomen: Understanding its purpose and potential outcomes
Low Anterior Resection (LAR) surgery is a common treatment method for stages I, II, and III rectal cancers. This major surgery, which typically takes around 4 hours to perform, involves the removal of the cancerous portion of a person's rectum, sometimes along with healthy noncancerous tissue and lymph nodes.
The surgery can be performed through open surgery, with a single long incision, or minimally invasive methods such as laparoscopic or robotic-assisted surgery. The latter uses several small incisions and may include a robotic device for assistance, aiming to reduce recovery time and minimize scarring.
Following the surgery, most people will spend a few days in the hospital. The length of stay can vary depending on the type of surgery, how it went, and the individual's overall health. Recovery at home usually takes about 3-6 weeks.
During recovery, a person may need to follow a BRAT diet to control frequent bowel movements, regularly clean and dress their incision wounds, stay hydrated, avoid strenuous exercise and activity, and have their ileostomy cared for by a WOC nurse (Wound, Ostomy, and Continence nurse).
Possible risks of LAR surgery include fistula, intestinal obstruction, peritoneal abscess, peritonitis, urinary problems, myocardial infarction (heart attack), pulmonary thromboembolism, and brain injury. It's essential to discuss these risks with your surgical team before the procedure.
Before LAR surgery, it's crucial to inform your surgical team about medications you take, smoking habits, alcohol consumption, and sleep apnea. Preparation steps may include pre-surgical testing, meeting with a nurse practitioner, meeting with a wound, ostomy, and continence nurse, identifying a caregiver, filling out a healthcare proxy form, and following all recommendations and guidance provided by the healthcare professional.
It's important to note that an abdominoperineal resection (APR), a more invasive procedure, involves the removal of the anus, rectum, and a portion of the sigmoid colon. This procedure results in a comparably lower quality of life and is not typically the first choice for treating colorectal cancer.
A high anterior resection is similar to LAR, but surgeons make a higher incision to remove part of the left side of the colon, upper rectum, and surrounding lymph nodes. Both LAR and high anterior resection are major surgeries requiring weeks of recovery.
A 2019 study suggests that emergency LAR surgery may limit a surgeon's ability to remove the cancer and preserve tissue, and may increase the likelihood of postoperative complications. Therefore, it's essential to discuss the timing of the surgery with your healthcare team.
After LAR surgery, most people wake up in the post-anesthesia care unit of the hospital, where their recovery is monitored. If necessary, a person may receive oxygen through a mask or a tube inserted into the nose during recovery. A person may also have a catheter and one or two drains in their lower abdomen after the surgery.
In conclusion, LAR surgery is a significant step in the treatment of colorectal cancer. Understanding the process, potential risks, and recovery period can help individuals prepare for this life-changing procedure. Always consult with your healthcare team for personalised advice and guidance.
