[Low Anterior Resection Syndrome - Diagnosis - Therapy - Prophylaxis]

As 5-year survival after rectal cancer surgery has reached 80%, there is increasing interest in quality of life. Low anterior resection syndrome (LARS) is an overall measure of the postoperative functional disorder due to the surgical resection.

A thorough review of the literature was undertaken to help to define LARS and develop an understanding of its pathophysiology, diagnosis, therapy, and prophylaxis.

LARS is observed after up to 80% of stoma sparing procedures performed for rectal carcinoma. The capacity of the rectal remnant as well as intraoperative damage to neuronal structures seem to be the most important pathogenetic factors resulting in a substantial impairment of the quality of life. Pelvic floor rehabilitation, rectal balloon distension training, biofeedback, anal irrigation, and sacral nerve stimulation are multimodal treatment options for LARS.

Various therapeutic approaches exist to attenuate the consequences of LARS for the individual patient. Nevertheless, considerable work has to be done in the future not only to improve survival but also the quality of live after rectal carcinoma.