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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Low Anterior Resection Syndrome.

Theresa H Nguyen1,2, Reena V Chokshi3

  • 1Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, 7200 Cambridge Ave., Ste. 8B, BCM 901, Houston, TX, 77030, USA.

Current Gastroenterology Reports
|August 5, 2020
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Summary

Low anterior resection syndrome (LARS) significantly impacts quality of life after rectal cancer surgery. Early assessment and treatments like irrigation and biofeedback can improve outcomes, with stoma considered for refractory cases.

Keywords:
Fecal incontinenceInternal anal sphincterLow anterior resection syndromeRectal cancerUrgency

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Oncology

Background:

  • Low anterior resection syndrome (LARS) is a common complication following sphincter-sparing rectal cancer surgery.
  • LARS significantly impairs patients' quality of life due to functional bowel disturbances.

Purpose of the Study:

  • To review the major features and pathophysiology of LARS.
  • To discuss current and emerging treatment approaches for LARS.

Main Methods:

  • Literature review summarizing current understanding of LARS.
  • Analysis of pathophysiology involving mechanical and neural pathways.
  • Evaluation of diagnostic tools including scoring systems and anorectal manometry.

Main Results:

  • Quality of life is strongly correlated with LARS severity.
  • Anorectal manometry shows decreased sphincteric function post-surgery, with potential for recovery.
  • Transanal irrigation, pelvic floor rehabilitation, and biofeedback are primary treatments for major LARS.

Conclusions:

  • LARS management requires prompt assessment and tailored therapy.
  • A spectrum of treatments exists, from conservative measures to sacral nerve stimulation.
  • Further research, including RCTs, is needed for risk stratification and severity-based treatment algorithms.