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 ◽  
...  

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.

2021 ◽  
Vol 20 (1) ◽  
pp. 59-67
Author(s):  
A. B. Serebriy ◽  
E. A. Khomyakov ◽  
I. O. Nafedzov ◽  
O. Yu. Fomenko ◽  
E. G. Rybakov

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.


2014 ◽  
Vol 57 (5) ◽  
pp. 585-591 ◽  
Author(s):  
Therese Juul ◽  
Madelene Ahlberg ◽  
Sebastiano Biondo ◽  
Eloy Espin ◽  
Luis Miguel Jimenez ◽  
...  

2019 ◽  
Vol 28 (3) ◽  
pp. 1199-1206 ◽  
Author(s):  
Ali Bohlok ◽  
Camille Mercier ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Luigi Moretti ◽  
...  

2019 ◽  
Vol 37 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Maarten van Heinsbergen ◽  
Jeroen W. Leijtens ◽  
Gerrit D. Slooter ◽  
Maryska L. Janssen-Heijnen ◽  
Joop L. Konsten

Background/Aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three ­patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the ­European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. “Major LARS” was observed in 29% of patients and “minor LARS” in 26%. Female gender (OR 4.00; 95% CI 1.20–13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08–12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01–1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.


2021 ◽  
Vol 19 (Sup4a) ◽  
pp. S15-S20
Author(s):  
Jennie Burch

Rectal cancer is common and is often treated with surgical removal of the rectum, potentially including chemoradiation. Despite improvements in surgical technique, this treatment often results in long-term negative consequences. The most common of these symptoms involve bowel dysfunction, such as faecal incontinence, constipation and urgency, and are collectively termed low anterior resection syndrome (LARS). These often negatively impact on quality of life in a number of areas, including work, relationships and mental wellbeing. These symptoms can be eased with conservative management techniques, such as dietary modification, pelvic floor exercises and medication. If these are insufficient, patients can try specialist nurse-led interventions, including biofeedback, hypnotherapy, nerve stimulation and/or transanal irrigation. If these management options do not provide adequate quality of life, a permanent colostomy can be formed. It is important for nurses to recognise that problems can occur after treatment for rectal cancer and assist patients to overcome these problems and improve their quality of life.


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