Optimizing sacral neuromodulation for low anterior resection syndrome: learning from our experience

Area of Science:

• Colorectal Surgery
• Neuromodulation
• Gastroenterology

Background:

• Low anterior resection syndrome (LARS) significantly impacts quality of life after rectal cancer surgery.
• Sacral neuromodulation (SNM) is an emerging treatment option for refractory LARS symptoms.

Purpose of the Study:

• To review institutional outcomes of SNM for LARS.
• To identify factors associated with therapeutic success in SNM for LARS.

Main Methods:

• Retrospective review of 25 patients treated with SNM for LARS (2008-2019).
• Evaluation using LARS and Wexner scores pre- and post-SNM.
• Patient satisfaction assessed via visual analogue scale (VAS).

Main Results:

• Significant improvements observed in both LARS (37.82 to 29) and Wexner scores (16.24 to 11.13) post-SNM (P < 0.004).
• Higher anastomosis height correlated with greater LARS score changes (P=0.035).
• Patients receiving radiotherapy reported lower satisfaction (6.38) vs. those without (8.22) (P=0.008).
• Positive association found between Wexner score improvement and patient satisfaction (P=0.001).

Conclusions:

• SNM effectively improves LARS and Wexner scores.
• Patient satisfaction is linked to symptom improvement.
• Radiotherapy history and anastomosis height may influence SNM outcomes in LARS patients.