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A systematic review of preoperative radiological factors associated with the development of low anterior resection syndrome (LARS)

  • 0Department of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy.
Updates in Surgery +

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April 5, 2025

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April 5, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Radiological changes on preoperative MRI predict low anterior resection syndrome (LARS). Specific anatomical features like pelvic floor muscle volume and anorectal joint thickness are associated with LARS development after surgery.

Area Of Science

  • Colorectal surgery
  • Radiology
  • Oncology

Background

  • Low anterior resection syndrome (LARS) is a common complication after rectal cancer surgery.
  • Identifying predictors of LARS is crucial for improving patient outcomes and quality of life.

Purpose Of The Study

  • To systematically review evidence on preoperative radiological predictors of postoperative LARS.
  • To summarize findings from studies using Magnetic Resonance Imaging (MRI) to identify anatomical characteristics associated with LARS.

Main Methods

  • Systematic literature search of MEDLINE, EMBASE, and CENTRAL databases up to October 2024.
  • Inclusion of retrospective studies analyzing preoperative MRI in patients who underwent low anterior resection (LAR).
  • Assessment of radiological features and their correlation with LARS scores.

Main Results

  • Specific preoperative MRI findings were associated with LARS.
  • Pubococcygeus + iliococcygeus muscle volume (OR 14.7, p=0.02) and mesorectal/pelvic volumes (p<0.001) were linked to major LARS.
  • Anorectal joint thickness (OR 0.653, p=0.001) showed a significant association, particularly after neoadjuvant chemoradiotherapy.

Conclusions

  • Preoperative radiological characteristics, especially those related to pelvic floor musculature and pelvic volumes, can predict LARS.
  • Further prospective studies are needed to validate these findings and explore other imaging modalities like ultrasound and defecography.

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