Patient Education Colorectal Cancer: Your Care and Recovery | Page 17

Rectal Cancer Surgery
Surgical options for rectal cancer depend on the location of the tumor in the
rectum, its size, and whether or not lymph nodes are involved. The goals of
surgery are to remove as much of the cancer from the body as possible and
to preserve the anal sphincter (the muscle that controls bowel movements)
and good bowel function whenever possible.
Surgery for small rectal tumors is called local excision. If the cancer is small
and has not grown beyond the inner layers of the rectum where it started, it
may be removed through the anus. This is called transanal excision.
Surgery for larger tumors is more involved. Some of the procedures used
include:
❒ Ostomy (Colostomy, Iliostomy)
If your cancer requires removal of significant parts of your rectum or
anus, your surgeon may perform a colostomy. See pages 44-45.
❒ Lower Anterior Resection (LAR)
This is used to remove the tumor and lymph nodes when the cancer is
located high in the rectum, above the anus. The cut ends of the rectum
are sewed or stapled together. Stool (solid waste) can then pass normally
through the anus, so a colostomy is not needed. Sometimes the surgeon
will create a temporary ostomy so the rectum can heal.
❒ Total Mesorectal Excision (TME)
This is a specialized technique that removes the rectum as well as the fat,
blood vessels, and lymph nodes around it in one careful piece. Studies
have shown that TME is good for lowering the risk of cancer coming back
in the same place.
❒ Sphincter-Sparing Surgery
Special techniques are done to help remove even low rectal tumors
without injuring or removing the anal sphincter. This means you are
less likely to need a permanent colostomy. Chemotherapy and radiation
before surgery may further reduce the need to remove the anal sphincter.

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