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Impact of a Patient-centered Program for Low Anterior Resection Syndrome: A Multicenter, Single-blinded, Randomized
Richard Garfinkle1, Marie Demian1, Sarah Sabboobeh1
1Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Annals of Surgery
|June 12, 2025
Summary
A new patient-centered program significantly improved quality of life for patients experiencing Low Anterior Resection Syndrome (LARS) after surgery. This nurse-guided self-management intervention offers a better approach to LARS treatment.
Area of Science:
- Colorectal surgery outcomes
- Patient self-management interventions
- Quality of Life (QoL) research
Background:
- Low Anterior Resection Syndrome (LARS) significantly impacts patient quality of life post-surgery.
- Current LARS self-management strategies are often unguided and yield limited success.
- A structured, patient-centered approach is needed to address LARS symptoms effectively.
Purpose of the Study:
- To evaluate the impact of a Low Anterior Resection Syndrome (LARS) Patient-Centered Program (LARS-PCP) on global quality of life (QoL).
- To compare the LARS-PCP, an informational and guided self-management intervention, against standard care.
- To assess QoL outcomes 6 and 12 months post-ostomy closure following restorative proctectomy.
Main Methods:
- A multicenter randomized controlled trial involving 160 adult patients undergoing restorative proctectomy with ostomy closure.
- Participants were randomized 1:1 to either the LARS-PCP (informational tool and nursing support) or Standard Care.
- Patient-reported outcomes, including global QoL, were measured over a 12-month follow-up period.
Main Results:
- The LARS-PCP group demonstrated significantly higher global QoL at 6 months (79.7 vs. 67.8, P=0.001) and 12 months (82.0 vs. 74.9, P=0.036) post-ostomy closure.
- A lower incidence of major LARS was observed at 1 month postoperatively in the LARS-PCP group (60.0% vs. 81.7%, P=0.008).
- QoL improvements associated with the LARS-PCP were sustained throughout the follow-up period.
Conclusions:
- Nurse-guided self-management through the LARS-PCP significantly improves QoL after restorative proctectomy.
- This study provides the first multicenter randomized controlled trial evidence for the efficacy of a structured LARS intervention.
- The LARS-PCP represents a valuable advancement in managing LARS and enhancing patient recovery.
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