Low anterior resection syndrome (LARS): cause and effect and reconstructive considerations

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Oncology

Background:

• Low anterior resection syndrome (LARS) is a common postoperative complication following rectal surgery.
• It presents as a cluster of symptoms including fecal urgency, frequency, fragmentation, and incontinence.
• The multifactorial etiology involves sphincter injury, altered anorectal physiology, and neurological damage.

Purpose of the Study:

• To review the contributing factors to low anterior resection syndrome (LARS).
• To analyze the short- and medium-term functional outcomes of different neorectal reconstructions for LARS.
• To compare the efficacy of various neorectal reservoir techniques in managing LARS.

Main Methods:

• Literature review of comparative trials on neorectal reconstructions.
• Analysis of factors contributing to LARS symptomatology.
• Evaluation of functional results from different surgical techniques.

Main Results:

• LARS significantly impacts patient quality of life after low anterior resection.
• Neorectal reservoir construction, including colonic J-pouch, transverse coloplasty, and side-to-end anastomosis, can alleviate LARS symptoms.
• Comparative data on the functional outcomes of these reconstructions are crucial for patient management.

Conclusions:

• Understanding LARS etiology is key to developing effective management strategies.
• Neorectal reservoir construction is a viable option to improve functional outcomes post-LARS.
• Further comparative studies are needed to optimize surgical techniques for LARS management.