Distinct trajectories of low anterior resection syndrome following ileostomy reversal.

Purpose: This study is an midterm postoperative assessment of LARS symptoms, aiming to apply group-based trajectory modeling to analyze the symptom trajectories of low anterior resection syndrome in rectal cancer patients who underwent ileostomy and subsequent reversal, and to investigate the clinical and treatment-related factors influencing these trajectories. Methods: A retrospective cohort of 134 rectal cancer patients who underwent low anterior resection with diverting ileostomy and subsequent reversal was analyzed. LARS scores were recorded at 3, 6, 9, and 12 months postoperatively. GBTM was used to classify patients into symptom trajectory groups. Multinomial logistic regression identified clinical factors associated with each trajectory. Results: Among 134 rectal cancer patients included, group-based trajectory modeling identified three LARS symptom trajectories following stoma reversal: mild and recovering (30.6%), moderate and fluctuating (40.3%), and severe and persistent (29.1%). Over the 12-months follow-up, LARS scores declined overall, with significant differences in symptom severity observed among the three groups at all time points ( Conclusion: Preoperative radiotherapy, low anastomotic height, and advanced tumor stage significantly increase the probability of following a severe and persistent LARS trajectory. Recognizing these factors as probabilistic risks rather than absolute determinants may facilitate early tailored interventions and enhance personalized postoperative recovery.