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Low anterior resection syndrome phenotypes-Different symptom profiles for different patients
Sireesha Koneru1,2,3, Julie Cornish4,5, Pierre H Chapuis1,2,3
1Concord Repatriation General Hospital, Concord Institute of Academic Surgery, Sydney, New South Wales, Australia.
Bowel dysfunction after colorectal cancer surgery significantly impacts patient satisfaction and quality of life. Addressing evacuatory and storage symptoms is crucial for improving outcomes following anterior resection (AR).
Area of Science:
- Colorectal cancer (CRC) survivorship research.
- Gastrointestinal surgery outcomes.
- Patient-reported functional outcomes.
Background:
- Functional outcomes are increasingly central to colorectal cancer (CRC) survivorship.
- Existing literature may underestimate the impact of evacuatory dysfunction on patient satisfaction post-anterior resection (AR) for CRC.
- Understanding post-AR bowel dysfunction is vital for improving patient well-being.
Purpose of the Study:
- To investigate the impact of post-AR storage and evacuatory dysfunction symptoms on patient satisfaction.
- To assess the effect of these symptoms on health-related quality of life (HRQoL).
- To highlight the importance of documenting specific bowel dysfunction symptoms.
Main Methods:
- Cross-sectional study of 248 patients post-AR for CRC (2012-2021) at an Australian hospital.
- Utilized validated scores: Low Anterior Resection Syndrome (LARS), St Mark's incontinence, Cleveland Clinic constipation, and Altomare obstructive defaecation syndrome.
- Assessed patient satisfaction (Likert scale) and HRQoL (SF36v2®), using linear regression to analyze symptom associations.
Main Results:
- Six evacuatory dysfunction symptoms (e.g., straining, unsuccessful attempts, digitation) and four storage symptoms (e.g., flatus leakage, urgency) negatively impacted patient satisfaction.
- A significant proportion of patients experienced evacuatory dysfunction, even those with 'no LARS' (44.5%).
- Both storage and evacuatory dysfunction symptoms were associated with reduced patient satisfaction and HRQoL.
Conclusions:
- Postoperative storage and evacuatory dysfunction symptoms adversely affect patient satisfaction and HRQoL after AR.
- Comprehensive documentation of evacuatory dysfunction symptoms is essential for patient care.
- Further research is needed to develop patient satisfaction-weighted HRQoL instruments specific to LARS.
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