Anterior Resection of the Rectum

The operation

The rectum is attached to the anal muscles which control when you have your bowels opened. The diagrams below show the part of your large bowel, near your bottom, which will be removed during the operation. The two ends will be joined together. This is called an ANASTOMOSIS. This is a delicate procedure and it is important that you understand the possible problems you may encounter.

Before the operation

  • You will have lots of routine tests to ensure that you are fit enough for surgery.
  • You may also have medicine to empty your bowel completely. This makes your bowel as clean as possible for the surgeon.
  • You will have only CLEAR FLUIDS for the 24 hours prior to your operation and you MAY require a drip.

When you wake up after the operation you will have some or all of the following:

  • A wound on your tummy with stitches or clips, covered with a dressing.
  • A drip to give you fluids and medicines. YOU MAY NOT BE ALLOWED TO DRINK OR EAT FOR SEVERAL DAYS as your bowel has had a ‘shock’ during the operation and will not work properly at first.
  • A tube in your nose that will keep your stomach empty.
  • A catheter – a small tube to keep your bladder empty.
  • You may have a DRAIN, a small tube to clear away any oozing fluids around the operation site inside. This helps to prevent infection.
  • You may have a stoma appliance (bag) on your tummy.
  • You may have an epidural (a fine tube in your back) OR pump (a line in your arm) which gives you pain relieving medicines.
  • You may have a fine tube in your neck to help measure the amount of fluid being put into your body accurately.

It will take up to about a week to get rid of all these things, during which time the nurses will help you to wash, clean your mouth and enable you to move both in and out of bed.

After several days you may feel that you want to pass wind or have your bowels opened. Even if you have a stoma this is entirely NORMAL and you may pass a little old blood or mucus (slime). Please keep the nurses informed.

Other experiences you may have are:

  • A sore bottom
  • Constipation and/or diarrhoea
  • Frequent small bowel actions
  • A lack of control of your bowels which may mark your underclothes. This improves over a short period of time.
  • ANXIETY due to the whole situation.

These are all expected occurrences.

Please talk to one of the nurses about them as they can usually be helped with patience and further information.

It may be helpful for you to do some pelvic floor exercises. These will enable your bottom muscles to cope with the removal of you back passage. The best one to do is simply tightening up your bottom or trying to stop the flow of urine when you go to pass water.

Risks and Benefits

Risks of this operation are small and much less than the risk of doing nothing but nonetheless this is a major operation and some people (less than 1-2%) do not survive such surgery.

  • All operations carry a risk from anaesthetics but this is minimal due to modern techniques.
  • Because of the nature of the surgery there is a risk of injury to the bladder and the pelvic nerves that affect sexual function.

Your stoma care/specialist nurse or surgeon will discuss this further when you are asked to sign a consent form for the operation.

Whilst it is important that you understand what the surgeon means by this operation, you will probably have been told that you may, or may not have to have a COLOSTOMY or ILEOSTOMY (stoma for short) either temporarily or permanently. This is a very frightening concept to many people and the stoma care nurses will give you a booklet explaining what a stoma is and offer you support and practical help.