Prevalence Of Low Anterior Resection Syndrome Research Articles

Robotic intersphincteric resection of low rectal cancer versus laparoscopic intersphincteric resection of low rectal cancer

This systematic review evaluated and compared the two currently available intersphincteric resection techniques (robotic and laparoscopic intersphincteric resection) for low rectal cancer, with the final aim of comparing associated factors between the two techniques. The assessed factors included surgical duration, hospital stay, complications, overall survival, local recurrence, and low anterior resection syndrome (LARS). A literature search of the search engines “PubMed”, “SCOPUS”, and “Web of Science” was conducted, with a time interval set between 2015 and 2023. The initial search yielded 57 studies, of which 10 met the inclusion and exclusion criteria. Hence, data was extracted from only these 10 studies. The average reported robotic surgery time varied between 197 and 472 mins, while the laparoscopic surgery time varied between 240 and 325 mins. Conversely, the overall survival and local recurrence rates were 89.7% and 6.7% for robotic and 87.9% and 6.2% for laparoscopic resection, respectively. In addition, complications were reported in 16.5% and 18.2% of robotic and laparoscopic resection cases, respectively. This systematic review showed that although the surgery duration is longer in robotic resection compared to laparoscopic resection, the former technique is associated with lower rates of complications and local recurrence, and improved overall survival. In addition, few studies have reported on the prevalence of LARS; therefore, we recommend that this field be studied and included in the reported data of the upcoming studies to allow more conclusive evidence regarding prevalence of LARS among the two groups of intersphincteric resections.

Prevalence and Risk Factors of Low Anterior Resection Syndrome in Epithelial Ovarian Cancer Surgery.

BackgroundIn this study, we aimed to determine the prevalence and risk factors of low anterior resection syndrome (LARS) in epithelial ovarian cancer (EOC) surgery.MethodologyA descriptive cross-sectional study was conducted at the Gynecologic Oncology Section of the Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan. Using non-probability consecutive sampling technique, all patients who underwent cytoreductive surgery involving low anterior resection for EOC between January 2016 and January 2021 were included. Patients were assessed for LARS symptoms using the LARS score, along with its risk factors. Descriptive statistics, that is, continuous variables were expressed as the median and interquartile range, while categorical variables were expressed as frequencies and percentages. The LARS score was categorized according to a two-tier model with “no or minor LARS” and “major LARS.” Univariate analyses were performed by the chi-square tests providing odds ratios and 95% confidence intervals to identify risk factors for major LARS.ResultsOverall, 95% of cases had LARS scores that fell in “no or minor LARS,” while only 5% of cases had “major LARS.” Univariate analyses relieved no statistically significant association between the occurrence of major LARS and any of the risk factors.ConclusionsThe prevalence of LARS was 5%, and no risk factors were associated with major LARS in our study population.

Prevalencija sindroma niske prednje resekcije kod bolesnika sa karcinomom rektuma koji su bili podvrgnuti hirurškom lečenju u Gradskoj bolnici Isfahan tokom 2012-2018

Objective. We aimed to determine the relative frequency of low anterior resection syndrome (LARS) in patients with rectal cancers who underwent surgical treatment in Isfahan. Methods. We evaluated all patients who were referred to the surgery clinic of Saint Al-Zahra hospital in Isfahan within six years. If LARS was identified, according to the LARS score tool, the frequency of resection complications, factors affecting the LARS, morbidity, and mortality, the frequency distribution of defecation, stool consistency, and rate of significant improvement was evaluated. Results. Fifty-two patients were evaluated. The prevalence of LARS was 78.8%. Postoperative fecal and gas incontinence, clustering, fecal frequency, and fecal urgency in LARS patients were significantly higher than in patients without LARS (P<0.05). There was no significant difference between the two groups in terms of factors affecting the LARS (p<0.05). In most of the patients with LARS, the defecation frequency was more than seven times a week (82.1%), and they mostly had liquid stool (61.5%). 95.5% of the patients with LARS showed significant improvement, which was mostly after 7-11 months (38.5). There was a significant difference between the frequency distribution of defecation, stool consistency, and significant improvement status in patients with and without LARS. Conclusion. LARS occurs commonly among patients undergoing LAR with TME and it is associated with more resection complications. Patients with LARS have significantly higher frequency of defecation per week and liquid stools and mostly achieve significant improvements. Other factors might not be significantly different between patients with or without LARS.

Awareness and management of low anterior resection syndrome: A Dutch national survey among colorectal surgeons and specialized nurses

IntroductionSubstantial progress has been made in the treatment of rectal cancer in the past two decades. Low anterior resection is a cornerstone in current treatment, combined with neo-adjuvant (chemo-) radiation in selected cases. However, side effects such as increased frequency, urgency and incontinence are seen in a majority of patients postoperatively. These symptoms, referred to as low anterior resection syndrome (LARS), have a severe impact on quality of life. Management of LARS is complex, and surgeons seem to underestimate and misinterpret the impact of symptoms associated with LARS. Aim and methodsWe investigated the awareness and management of LARS in The Netherlands, conducting a national survey in which colorectal surgeons and colorectal care nurses were asked for their views on this complex syndrome. Results242 health-care professionals participated in the survey. Most participants estimate the prevalence of major LARS is 20–40% after low anterior resection (LAR); a severe underestimation of actual prevalence - around 70%. Only 10% of surgeons use LARS screening tools in the preoperative period, and fewer than half of surgeons use LARS scores before or after a LAR. Although most surgeons inform their patients preoperatively about the changes in bowel function that they may experience after rectal cancer treatment, a majority of these surgeons indicate more information and patient counselling would improve the quality of life of their patients. DiscussionImpact and prevalence of LARS is underestimated by their physicians. Uniform clinical guidelines should be developed to guide physicians in adequate management of patients with LARS.