What type of ostomy is expected with LAR procedure?

• A. Temporary loop ileostomy or loop colostomy; Double-barrel transverse colostomy
• B. Permanent sigmoid colostomy
• C. Permanent ileostomy
• D. No ostomy

Answer: (A)

When a low anterior resection is done, the goal is to preserve the anal sphincter and restore continuity, but the new connection is delicate and at risk for leakage. To protect this anastomosis, surgeons often create a temporary diverting ostomy. The most common forms are a loop ileostomy or a loop colostomy, and a loop or double-barrel transverse colostomy may be used when diversion is needed from a higher or different segment. These diversions are meant to be temporary and are reversed once healing is secure. Permanent ostomies aren’t usually planned after a standard LAR because the intention is sphincter preservation and restoration of continuity; and not having an ostomy would leave the new connection unprotected.