The incidence and risk factors of low anterior resection syndrome (LARS) after sphincter-preserving surgery of rectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rui Sun ◽  
Ziyi Dai ◽  
Yin Zhang ◽  
Junyang Lu ◽  
Yuelun Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Meta Analysis ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

scholarly journals A meta-analysis of the prevalence of Low Anterior Resection Syndrome and systematic review of risk factors

2018 ◽  
Vol 56 ◽  
pp. 234-241 ◽  
Author(s):  
Alexander D. Croese ◽  
James M. Lonie ◽  
Alexandra F. Trollope ◽  
Venkat N. Vangaveti ◽  
Yik-Hong Ho
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Meta Analysis ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

scholarly journals Low Anterior Resection Syndrome in Adults with Rectal Cancer in China: a Case Series Analysis

2021 ◽  
Author(s):  
Yuan Qiu ◽  
Yu Pu ◽  
Haidi Guan ◽  
Weijie Fan ◽  
Shuai Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Recovery Time ◽  
Colorectal Anastomosis ◽  
Postoperative Recovery ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Lars Score

AbstractLow anterior resection syndrome (LARS) comprises a collection of symptoms affecting patients’ defecation after restorative surgery for rectal cancer. The aim of this work was to study the incidence and risk factors for LARS in China. Rectal cancer patients undergoing total mesorectal excision and colorectal anastomosis between May 2012 and January 2015 were identified from a single center. The patients completed the LARS score questionnaire through telephone. The clinical and pathological factors that may influence the occurrence of LARS were analyzed using univariate and multivariate logistic regression analysis. The influence of postoperative recovery time and pelvic dimensions on the occurrence of LARS was also analyzed. This study included 337 patients, at an average age of 61.03 SD11.32. The mean LARS score of the patients was 14.08 (range 0–41). A total of 126 patients (37.4%) developed LARS after surgery, including 63 (18.7%) severe cases. Compared with the scores within the initial 6 postoperative months, the LARS scores of the patients in 6~18 months after the surgery showed significant reductions (p < 0.01). In multivariate analysis, lower locations of anastomosis, pre-surgery radiotherapy, and shorter postoperative recovery time were significant predisposing factors for LARS. A subgroup analysis revealed that patients suffering from LARS over 18 months after surgery were found to have a significantly shorter interspinous distance than those without LARS (p < 0.05). LARS could improve over time after surgery. Lower anastomotic level and pre-surgery radiotherapy are risk factors for LARS.

scholarly journals Risk factors for major low anterior resection syndrome: meta-analysis and systematic literature review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Evgeny A. Khomyakov ◽  
Islam O. Nafedzov ◽  
Oksana Y. Fomenko ◽  
Mikhail V. Alekseyev ◽  
Sergey A. Frolov ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Statistical Analysis ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Meta Analysis ◽  
Anastomotic Leaks ◽  
Functional Impairments ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

Introduction — Low anterior resection syndrome (LARS) is a socially significant problem that impedes social adaptation and contributes to deterioration of life quality in patients. The objective of this study was to search for the category of patients most prone to major LARS, as well as to identify the factors determining the severity of this syndrome manifestations. Material and Methods — Systematic review and meta-analysis were performed according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The study selected publications that included the functional results of treatment of patients operated for rectal cancer. Functional impairments were assessed according to the international LARS Score. Statistical analysis was performed using the inverse-variance weighted average method (IVW) with calculation of the odds ratio logarithm and standard error of the mean. Results — After a critical search and analysis of all literature sources, eight studies were found suitable for meta-analysis. In total, 1042 patients (796 men and 246 women) were included into statistical analysis, 409 of which (39.2%) had symptoms of major LARS. Chemotherapy was performed on 637 (62.5%) patients, while 568 subjects (55.5%) underwent radiation therapy, and anastomotic leaks were described in 89 (8.5%) people. According to the results of the meta-analysis, statistically significant factors were: preventative ostomy (OR=3.32, 95% CI 1.99-5.55, p<0.00001), chemotherapy (OR=1.98, 95% CI 1.23-3, 19, p=0.005), radiation therapy (OR=5.00, 95% CI 2.73-9.13, p <0.00001), anastomotic leaks (OR=2.93, 95% CI 2.30-3, 73, p<0.00001), anal verge distance from anastomosis site (OR=2.61, 95% CI 1.47-4.62, p=0.001). Conclusion — The results of our meta-analysis allowed us identifying the group of rectal cancer patients most vulnerable to LARS. The risk of developing severe functional disorders is significantly higher in patients with low colorectal anastomosis, as well as in patients undergoing neoadjuvant radiation therapy.

scholarly journals Two dominant patterns of low anterior resection syndrome and their effects on patients’ quality of life

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Jung Kim ◽  
Ji Won Park ◽  
Mi Ae Lee ◽  
Han-Ki Lim ◽  
Yoon-Hye Kwon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
University Hospital ◽  
Postoperative Treatment ◽  
Low Anterior Resection Syndrome ◽  
Cross Sectional ◽  
Anterior Resection Syndrome

AbstractTo identify low anterior resection syndrome (LARS) patterns and their associations with risk factors and quality of life (QOL). This cross-sectional study analyzed patients who underwent restorative anterior resection for left-sided colorectal cancer at Seoul National University Hospital, Seoul, Republic of Korea. We administered LARS questionnaires to assess bowel dysfunction and quality of life between April 2017 and November 2019. LARS patterns were classified based on factor analyses. Variable effects on LARS patterns were estimated using logistic regression analysis. The risk factors and quality of life associated with dominant LARS patterns were analyzed. Data of 283 patients with a median follow-up duration of 24 months were analyzed. Major LARS was observed in 123 (43.3%) patients. Radiotherapy (odds ratio [OR]: 2.851, 95% confidence interval [95% CI]: 2.504–43.958, p = 0.002), low anastomosis (OR: 10.492, 95% CI: 2.504–43.958, p = 0.001), and complications (OR: 2.163, 95% CI: 1.100–4.255, p = 0.025) were independently associated with major LARS. LARS was classified into incontinence- or frequency-dominant types. Risk factors for incontinence-dominant LARS were radiotherapy and complications, whereas those for frequency-dominant LARS included low tumor location. Patients with incontinence-dominant patterns showed lower emotional function, whereas those with frequency-dominant patterns showed lower global health QOL, lower emotional, cognitive, and social functions, and higher incidence of pain and diarrhea. Frequency-dominant LARS had a greater negative effect on QOL than incontinence-dominant LARS. These patterns could be used for preoperative prediction and postoperative treatment of LARS.

The impact of timing of stoma closure on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer

2021 ◽  
pp. 126-134
Author(s):  
Hemn Hussain Kaka Ali ◽  
Qalandar Hussein Abdulkarim ◽  
Karzan Seerwan ◽  
Barham M. M .Salih
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Anal Verge ◽  
Loop Ileostomy ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Closure Of Ileostomy ◽  
The Mean ◽  
The Impact

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.    

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