Dr. Sanjeev Kumar

Consultant - Surgical Oncology

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Reviewed by

Dr. Sanjeev Kumar

Consultant - Surgical Oncology

Manipal Hospitals, Delhi

Rectal Cancer And Sphincter Preservation Surgery

Reviewed by:

Dr. Sanjeev Kumar

Posted On: Apr 10, 2024

blogs read 4 Min Read

Rectal Cancer & Sphincter Preservation Surgery

What is Rectal Cancer?

Cancer is an uncontrolled growth that can happen anywhere in the body. Depending on the location of the cancerous growth it may be named after it. Rectal cancer is a type of cancer that develops in the rectum, the lower part of the large intestine. Sphincter Preservation Rectal Cancer Surgery is a type of surgery that aims to remove the cancer while preserving the anal sphincter muscles. These muscles allow you to control your bowel movements.

When might sphincter preservation be an option?

Sphincter preservation surgery may be an option for you if your rectal cancer is:

  • In the middle or upper part of the rectum

  • Low rectal cancers

  • Very low rectal cancers

  • Rectal cancer close to anal opening

To know more, visit the best cancer care hospial in Delhi.

Types of Sphincter-Preserving Surgery

There are a few different types of sphincter surgery, depending on the location and size of the tumor. Here are two common types:

  • Low Anterior Resection (LAR)

This surgery removes the rectum and the lower part of the sigmoid colon (the upper part of the large intestine). The remaining colon is then connected to the anus.

  • Ultra Low Anterior Resection (ULAR)

This surgery aims to remove low rectal cancers with sphincter preservation.

  • Inter sphincteric Resection (ISR) with Coloanal Anastomosis

ISR is an option in very low rectal cancers where sphincter preservation is not possible by conventional approach.

  • Trans anal Excision (TAE)

This surgery is for small cancers close to anal opening.

  • Trans-anal total mesocolic excision (TA-TME)

This is a novel approach which is done through trans-anal route using special GEL port and instruments.

  • Neo-sphincter

This is an option in highly motivated patients where sphincter is involved. New sphincter is created to restore the normal anal opening.

Role of Minimal Access surgery/ Key Hole surgery: Robotic surgery and Laparoscopy

Robotic and laparoscopic surgery aides in the surgery and sphincter preservation with magnified vision. It helps the surgeon perform complex surgery, low down in the pelvic cavity where access and vision is limited. Operating and doing open surgery in these areas is very difficult and challenging, risking vital organs and structures present in this region.

Benefits of Sphincter Preservation Surgery

There are several benefits to sphincter preservation surgery, including:

  • Reduced need for a Permanent Stoma/ostomy

An ostomy is a surgical opening created in the abdomen to allow waste to leave the body. Sphincter preservation surgery can help you avoid the need for a permanent ostomy.

  • Improved Quality of Life

Preserving the sphincter muscles allows you to maintain normal bowel control.

  • Better Body Image

Some people find that having an ostomy can affect their body image. Sphincter preservation surgery can help you maintain a more normal appearance.


Conventional treatment of these cancers is a radical surgery with loss of normal anal opening resulting in permanent stoma. With evolving surgical technique and advancements in Robotic surgery, Sphincter preservation is possible even in very low rectal cancer close to the anal opening. 

Cancer diagnosis and treatment is far more advanced now than ever before. Getting a timely diagnosis can help you find the treatment that suits your health needs. If you are considering sphincter preservation surgery, it is important to talk to an oncologist or cancer doctor about the benefits and risks of this type of rectal cancer surgery. Discussing previous medical history is important so as to avoid unnecessary complications.

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