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Management of Low Anterior Resection Syndrome (LARS) Following Resection for Rectal Cancer.
Harald Rosen1, Christian G Sebesta2, Christian Sebesta3
1Department of Surgical Oncology, Sigmund Freud University, 1020 Vienna, Austria.
Cancers
|February 11, 2023
Summary
Low anterior resection syndrome (LARS) significantly impacts quality of life after rectal surgery. Standardized treatment algorithms are crucial for managing LARS symptoms and improving patient outcomes.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Oncology
Background:
- Low anterior resection syndrome (LARS) affects 60-80% of patients post-rectal resection, causing severe functional issues.
- Symptoms include frequent defecation, urgency, clustering, and incontinence, significantly reducing quality of life (QOL).
- Pathophysiology involves impaired rectal motility due to radiotherapy, dissection, and excision.
Purpose of the Study:
- To review the pathophysiology of LARS.
- To evaluate evidence for available treatment options for LARS symptoms.
Main Methods:
- Narrative review of literature from Medline and Pubmed.
- Analysis of treatment options including medical therapy, dietary modification, pelvic floor rehabilitation, transanal irrigation (TAI), and neuromodulation.
Main Results:
- Medical therapies offer modest symptom control.
- Pelvic floor rehabilitation shows potential but lacks robust evidence.
- Transanal irrigation (TAI) demonstrates promising results, though further research is needed.
- Neuromodulation has limited application and conflicting outcomes.
Conclusions:
- LARS is a common, QOL-impairing condition following rectal surgery.
- Mandatory identification and treatment are essential during follow-up.
- A standardized treatment algorithm can effectively manage symptoms and improve QOL.
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