Anterior Resection Syndrome

Low rectal tumors have increasingly been treated by sphincter-saving operations (SSO), but some patients with a low anterior resection (LAR) or a coloanal anastomosis (CAA), with or without (chemo)radiotherapy, may suffer from a defecation disorder called “anterior resection syndrome” (ARS). Frequent bowel action, urgency, symptoms of fecal incontinence, that characterize anterior resection syndrome, may occur in 10 to 20% of patients after sphinctersaving operations. Quality of life may thus be impaired but the outcome may still be preferable to life with a permanent abdominal stoma and the individual learns to live with the consequences of treatment. Therefore ARS must be considered a significant issue of rectal cancer surgery and colorectal surgeons should know about this syndrome from top to bottom: its pathophysiology, clinical events, diagnostic tools, and therapy.