Low anterior resection (LAR) and abdominoperineal resection (APR) are the two primary operations for surgical resection of rectal cancer. The decision to perform one operation over the other is based primarily on the tumor location in relation to the sphincter complex. Low anterior resection involves resection of the tumor with a primary anastomosis to the remaining anorectum, thus maintaining intestinal continuity. It is usually reserved for tumors located between 4 and 16 cm from the anal verge. Abdominoperineal resection involves removing the tumor along with the anal canal and sphincter complex, creating a permanent end colostomy. To qualify for an LAR, both the tumor and the distal margin must allow preservation of the sphincter complex.