Understanding Sphincter Sparing Surgery for Colorectal Cancer

Sphincter sparing surgery is a specialized procedure for patients with colorectal cancer, aimed at removing cancerous tissue while preserving the anal sphincter. This type of surgery offers an alternative to traditional surgeries that often require a permanent colostomy, giving patients a better quality of life. Understanding the procedure, its benefits, and how it differs from traditional surgery can help you make informed decisions about your treatment options.

What Is Sphincter Sparing Surgery?

Sphincter sparing surgery, also known as low anterior resection (LAR) or ultra-low anterior resection, is a surgical technique used to remove tumors in the lower rectum while preserving the anal sphincter. The goal is to eliminate cancer while maintaining the patient’s ability to control bowel movements, avoiding the need for a permanent colostomy bag.

How Sphincter Sparing Surgery Differs from Traditional Surgery

In traditional colorectal cancer surgeries, especially for tumors located in the lower rectum, removing the tumor often results in the removal of the sphincter muscles, requiring a permanent colostomy. A colostomy involves diverting the end of the colon through an opening in the abdominal wall to collect stool in a colostomy bag.

Sphincter sparing surgery, on the other hand, aims to preserve as much of the rectum and sphincter muscles as possible. Surgeons use advanced techniques to remove the tumor while keeping the sphincter intact. This allows for normal bowel function post-surgery.

Benefits of Sphincter Sparing Surgery

The primary benefit of sphincter sparing surgery is that it offers a better quality of life by maintaining bowel control and avoiding a permanent colostomy. Other benefits include:

• Improved psychological well-being: Many patients experience relief knowing they can avoid a colostomy and maintain normal bowel function.
• Less invasive: In some cases, sphincter sparing surgery can be performed laparoscopically, resulting in smaller incisions, less pain, and quicker recovery times.
• Fewer lifestyle changes: Without a colostomy, patients face fewer adjustments and can often return to their normal routines sooner.

Who Is a Candidate for Sphincter Sparing Surgery?

Not every patient with colorectal cancer is a candidate for sphincter sparing surgery. The success of this procedure depends on several factors, including:

• Tumor location: The tumor must be far enough from the anal sphincter for surgeons to remove it while preserving the sphincter muscles.
• Tumor size: Smaller tumors that haven’t spread extensively are better candidates for sphincter sparing techniques.
• Stage of cancer: Early-stage colorectal cancers are more likely to be treated with sphincter sparing surgery. In advanced cases, other treatments may be necessary.

The physicians of Premier Surgical Lawson Group in Johnson City, TN, will evaluate your case and determine if sphincter sparing surgery is the best option for you.

The Procedure: What to Expect

Sphincter sparing surgery typically involves removing the cancerous portion of the rectum and then reconnecting the healthy parts of the bowel to allow for normal bowel function.

In some cases, a temporary ileostomy or colostomy may be needed, allowing the bowel to heal. This temporary diversion is often reversed after a few months, restoring natural bowel movements.

Recovery and Postoperative Care

Recovery from sphincter sparing surgery varies based on the type of procedure performed. Laparoscopic surgeries often result in shorter recovery times and less pain compared to open surgeries. During recovery, patients should expect:

• Hospital stay: Most patients are in the hospital for 4–7 days after surgery.
• Temporary bowel changes: Initially, bowel movements may be frequent or irregular, but they should stabilize over time.
• Diet and activity: A gradual return to normal eating and physical activity is recommended under the guidance of your healthcare provider.

Surgery Risks and Considerations

As with any surgery, sphincter sparing surgery carries certain risks, including:

• Infection: Surgical wounds or bowel reconnections may become infected.
• Leakage at the anastomosis: This occurs when the reconnected bowel doesn’t heal properly, leading to leaks and infections.
• Bowel dysfunction: Although the sphincter is preserved, some patients may experience bowel incontinence or urgency initially, but these issues often improve over time.

Sources:

https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/surgery/services-we-provide/colon-and-rectal-surgery/sphincter-sparing-surgery

https://drrajeevkapoor.com/what-is-sphincter-preservation-surgery-for-rectal-cancer/