Anterior resection surgery at Exeter Hospital

What is anterior resection surgery?

Anterior resection, also known as a bowel or colorectal resection, is a major bowel operation used to remove part of the rectum and the lower section of the colon (usually the sigmoid colon).

Our expert surgeons at Nuffield Health commonly perform this surgery to treat bowel cancer, but it may also be used for conditions such as diverticular disease, benign polyps, inflammatory bowel disease, strictures or other diseases affecting the lower bowel.

What are the different types of anterior resection?

Anterior resection is described according to how low in the rectum the bowel is removed:

• High anterior resection: Part of the sigmoid colon and upper rectum is removed.
• Low anterior resection: The mid rectum section is removed.
• Ultra-low anterior resection: The lower rectum, close to the anal canal, is removed.

Your consultant will recommend the most appropriate type based on the location of the disease.

What surgical approaches are used for anterior resection surgery?

Open anterior resection

Open surgery involves a single incision down the middle of your abdomen. It provides direct access to the bowel and may be recommended for complex disease, previous abdominal surgery or when keyhole surgery is not suitable.

Laparoscopic (keyhole) anterior resection

Keyhole surgery uses several small cuts and a camera to perform the operation. It usually results in less pain, a shorter hospital stay and quicker recovery.

Open vs laparoscopic anterior resection: which is right for me?

Your consultant will consider:

• The location and stage of your disease
• Your body shape and previous surgeries
• Your overall health
• Whether a stoma is likely.

Both approaches are safe and effective; the key difference is how the surgeon accesses the bowel.

How do I know if I need anterior resection surgery?

You may need anterior resection if you have:

• Cancer of the sigmoid colon or rectum
• Complicated diverticular disease
• Large or recurrent polyps
• Narrowing (stricture) of the bowel
• Severe inflammation or bleeding.

Your consultant will discuss your diagnosis, test results and treatment options with you.

Who is suitable for anterior resection?

Most people with disease in the lower bowel are suitable for this operation.

Who is not suitable?

You may not be suitable if:

• The cancer is too low to preserve the anal sphincter
• You have severe heart or lung disease
• You are unable to tolerate general anaesthetic.

What are the alternatives to anterior resection surgery?

Alternative options depend on your diagnosis and may include:

• Endoscopic removal of polyps
• Medical management for inflammatory bowel disease
• Watchful waiting for mild diverticular disease
• Abdominoperineal resection (APR) if the tumour is too low to preserve the anus.

Your consultant will explain whether these options are the right fit for you.

How should I prepare for anterior resection surgery?

Preoperative assessment

You will attend a pre-operative assessment where the team will:

• Review your medical history
• Check your blood pressure, heart and lung function
• Discuss your anaesthetic
• Explain your hospital stay and recovery.

Preparing in the days before surgery

• Follow any bowel preparation instructions
• Eat a balanced diet and stay hydrated
• Stop smoking if possible
• Tell the team about all medications, including blood thinners and supplements
• Arrange help at home for the first week after discharge.

What to bring on the day

• Comfortable clothing
• Medication list
• Any stoma supplies if you already have a stoma
• Personal items for your hospital stay.

What happens during anterior resection surgery?

Anterior resection is performed under general anaesthetic and usually takes 2–4 hours.

Open surgery

• Your surgeon will make a single incision down the middle of your abdomen
• The diseased section of your bowel is then removed
• The healthy ends are joined together, known as an anastomosis.
• A temporary stoma may be formed if needed
• The wound is closed with stitches or staples
• A drain may be placed to remove excess fluid
• A catheter may be inserted to help you pass urine.

Laparoscopic (keyhole) surgery

• Several small cuts are made
• A camera and instruments are inserted
• The bowel is removed and rejoined using the same principles as open surgery
• Recovery is often quicker.

Will I need a stoma after anterior resection?

A stoma may be needed if:

• The join is very low
• The bowel needs time to heal
• There is a higher risk of leakage.

Most stomas are temporary and can be reversed once healing is complete.

After the operation

You will wake up in the recovery area before returning to your room. You may have:

• A drip for fluids
• Pain relief (patient-controlled analgesia or epidural)
• A catheter
• A drain.

You’ll be encouraged to move around soon after surgery to reduce the risk of blood clots and lung problems. If you have a stoma, your healthcare team will teach you how to care for it before you go home.

How long does it take to recover from anterior resection surgery?

Hospital stay

Most patients stay in hospital for 3–7 days, depending on whether the surgery was open or laparoscopic.

Pain and mobility

Pain is normal after bowel surgery but can be managed with medication. You’ll be encouraged to walk regularly to help your recovery.

Eating and drinking

You may be able to eat and drink soon after surgery, but your intake may be restricted if your bowel is slow to wake up.

At home

• Expect to feel tired for several weeks
• Avoid heavy lifting for 6 weeks
• Build up gentle exercise gradually
• Wear compression stockings and take any prescribed medication to reduce the risk of blood clots
• Arrange a phased return to work if needed.

Bowel function

It can take time for your bowel to settle. You may experience:

• Urgency
• Frequent bowel movements
• Loose stools.

This is known as low anterior resection syndrome (LARS) and usually improves over time.

Sexual function

Some people notice temporary changes in sexual function. Your consultant will discuss this with you if it’s relevant to your surgery.

Follow-up

You’ll have regular follow up appointments to monitor your recovery and bowel function.

What are the risks and complications of anterior resection surgery?

As with any surgery, complications can occur, although they are uncommon.

General surgical risks may include:

• Bleeding (early or delayed)
• Infection
• Allergic reactions
• Blood clots.

Specific risks may include:

• Constipation or diarrhoea
• Leakage at the join (anastomotic leak)
• Damage to the bowel
• Reduced ability to hold stool
• Problems with a stoma
• Need for a permanent stoma
• Infection, bleeding or blood clots.

Your consultant will discuss your individual risk based on your health and diagnosis.

How much does anterior resection surgery cost at Nuffield Health?

For pricing information, select your local Nuffield Health hospital to find contact details and guide prices for liposuction. Please note that the guide price stated is an approximate cost of treatment only. You will be given a fixed all-inclusive price for treatment following your initial consultation with a consultant.