Dynamics in experiences, information and counselling needs of patients without or with minor LARS after rectal cancer...

After sphincter-sparing rectal cancer surgery many patients experience bowel dysfunction, known as low anterior resection syndrome (LARS). Major LARS significantly impacts quality of life (QOL). Patients without LARS or with minor LARS report fewer bowel-related issues This study aims to investigate the dynamics in the experiences, information and counselling needs of patients with or without minor LARS to create a comprehensive overview of LARS.

A grounded theory study was conducted. Adult rectal cancer survivors with no LARS or minor LARS were recruited from three large hospitals. Patients with major LARS, with a permanent stoma and non-Dutch-speaking patients, were excluded. Data collection involved semi-structured interviews, data were analysed using the constant comparative method and researchers' triangulation.

Fourteen patients were interviewed, six without LARS and eight with minor LARS. All patients reported LARS-related symptoms during the first months post-surgery, which impacted their QOL. Over time, symptoms became manageable and other long-term effects were perceived as more severe. Experiences were shaped by their perspective and context. Information needs varied, extensive information caused anxiety for some, but was crucial for preparation.

Patients with no or minor LARS experienced manageable symptoms that diminished in priority. Experiences were influenced by individual perceptions. Preoperative information should be adapted to minimize anxiety and align with patients' coping mechanisms. Healthcare providers should assess patients' risk of major LARS and engage them in shared decision-making, potentially using patient decision aids specifically designed for rectal surgery.