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International Journal of Colorectal Disease

, Volume 33, Issue 6, pp 787–798 | Cite as

Outcome of bowel function following anterior resection for rectal cancer—an analysis using the low anterior resection syndrome (LARS) score

  • Juliane Kupsch
  • Thomas Jackisch
  • Klaus E. Matzel
  • Joerg Zimmer
  • Andreas Schreiber
  • Anja Sims
  • Helmut Witzigmann
  • Sigmar Stelzner
Original Article
  • 252 Downloads

Abstract

Purpose

Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score.

Methods

We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire. Response rate was 78.8% (261 patients). The main outcome measure was the relation of the LARS score to potentially associated patient and treatment factors. Secondary endpoints were further measures that reflect anorectal dysfunction, e.g., Vaizey score.

Results

Overall, 144 (55.2%) patients exhibited scores > 20 reflecting minor (n = 51 (19.5%)) or major (n = 93 (35.6%)) LARS. A significant difference for scores > 20 was found for intersphincteric resection (IR, 73.2% affected patients) compared to total mesorectal excision (TME, 58.4%) and partial mesorectal excision (PME, 38.0%, p = 0.001). Radio(chemo)therapy resulted in LARS scores > 20 in 64.6% of patients compared to 43.1% in patients without irradiation (p = 0.001). Type of procedure (TME and IR as compared to PME), radio(chemo)therapy, and younger age were independently associated with LARS in logistic regression analysis. However, younger age remained the only independent factor for higher scores after exclusion of PME.

Conclusions

The LARS score identified a substantial proportion of patients after surgery for rectal cancer with anorectal dysfunction. The extent of surgical procedure is independently associated with the severity of symptoms whereas the role of radiotherapy needs further assessment.

Keywords

Low anterior resection syndrome Low anterior resection syndrome score Sphincter-preserving surgery Rectal carcinoma Anorectal function 

Notes

Acknowledgements

The authors are indebted to Lisa Domichowski, Medical Data Manager, for her support in data acquisition. The maintenance of the database at the Coloproctologic Unit of Dresden-Friedrichstadt General Hospital is supported by a grant from the Tumor Center Dresden.

Compliance with ethical standards

Ethical approval was obtained from the responsible ethics committee (Saxon Physicians Chamber, No. EK-BR-92/15-1/134619).

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General, Visceral and Thoracic SurgeryTeaching Hospital of the Technical University of DresdenDresdenGermany
  2. 2.Department of Surgery, University Hospital ErlangenFriedrich-Alexander University Erlangen-NürnbergErlangenGermany
  3. 3.Department of Radiation Therapy, Dresden-Friedrichstadt General HospitalTeaching Hospital of the Technical University of DresdenDresdenGermany

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