ArticleInternational journal of colorectal disease2025
Score assessment and treatment in patients presenting with low anterior resection syndrome after sphincter-sparing rectal cancer surgery.
Article in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Effect of psyllium husk on low anterior resection syndrome after rectal cancer surgery-a pilot prospective cohort study.Frontiers in surgery · 2025Article
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Abstract
backgroundSphincter-sparing low anterior resection (SSLAR) with neoadjuvant radio-chemotherapy has been developed to avoid abdomino-perineal amputation and permanent colostomy in patients with low rectal cancer. However, many patients develop symptoms known as low anterior resection syndrome (LARS), including fecal urgency, incontinence, and a sensation of incomplete evacuation. The Low Anterior Resection Syndrome Score (LARS Score), a validated tool developed by Emmertsen and Laurberg, is used to assess symptom severity and guide treatment. MATERIALS AND
methodsWe present a single-center cohort study including patients having undergone SSLAR for rectal cancer between 2014 and 2021 at Fribourg Cantonal Hospital. Initial LARS-scores were obtained by completion of the QoL questionnaire. Patients with minor LARS (scores 21-29) were treated with electrostimulation and bio-feedback physiotherapy. Those with major LARS (scores > 29) were first investigated by anal manometry followed by physiotherapy. All treatments took place in 2022/2023. After treatment, LARS-scores were calculated again.
resultsOf 54 patients included in the study, 18.5% had minor LARS, 40.8% major LARS, and 40.8% had no LARS. Of all patients with LARS, 18 (56%) completed pelvic physiotherapy, whereas 14 (44%) refused the treatment. Before and after pelvic physiotherapy, the median LARS score was 32 [interquartile range 29.50-38.50] and 22.5 [18.5-28], respectively (p < 0.001 according to Wilcoxon signed-rank test). Analysis of risk factors did not reveal any significant difference in age, gender, diabetes, nicotine or alcohol use, previous abdominal surgery, tumor stage, chemo/radiotherapy, type of operation and anastomosis, or anastomotic leakage.
conclusionsApproximately half of patients undergoing SSLAR experience LARS, and approximately one-third develop the major form. LARS scores may significantly improve with specific physiotherapeutic measures that have therefore been introduced as a standard procedure for all SSLAR patients at our institution.
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