Sphincter Sparing Rectal Surgery

Medically reviewed by: Gary H. Hoffman, MD

Los Angeles Colon and Rectal Surgical Associates often perform sphincter saving rectal surgery, offering patients an opportunity to maintain a higher quality of life after the treatment of rectal tumors.

What is Sphincter Sparing Rectal Surgery?

If a rectal tumor develops in close proximity to the anal sphincter (the muscle that controls continence), removing the tumor using traditional surgical techniques might leave the patient without an anal opening. This necessitates an ostomy, which is an opening on the abdominal wall that allows patients to have bowel movements into a pouch that is emptied from time to time by the patient. In addition, the operation may also interfere with sexual performance.

Fortunately, sphincter sparing rectal surgical procedures are available that allow for the removal of rectal tumors without impacting sphincter function and without the need to remove the anal opening. Some of these procedures include:

Neoadjuvant therapy. This treatment is given before surgery and consists of radiation and chemotherapy. The goal of neoadjuvant therapy is to shrink the tumor before surgery, increasing the possibility of your surgeon being able to perform sphincter sparing rectal surgery. Radiation and chemotherapy are given for about 6 weeks and then surgery is performed approximately 6 weeks after the treatment has ended.

Local excision. This procedure removes the rectal tumor through the anus instead of the abdomen. It often requires only an overnight stay in the hospital, followed by a quick recovery.

Coloanal J pouch. During this rectal surgery, the tumor and entire rectum are removed, but the anal canal and sphincter muscles are left in tact. A pouch is then created and attached to the remaining anus. This increases storage capacity while preserving continence.

Ileal pouch-anal anastomosis (IPAA). This operation is performed to remove the entire diseased colon and rectum. A pouch is then created and attached to the remaining anus. This increases storage capacity while preserving continence.

An experienced surgeon will be able to talk to you about the different options available and create a treatment plan that is most appropriate for your situation.

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