Low anterior resection syndrome: Real-world insights from an international survey

This study aimed to evaluate the global perspectives of healthcare professionals on LARS, including awareness, use of diagnostic tools, management strategies, resource access and multidisciplinary involvement, and to provide a contemporary international snapshot that identifies gaps in care and informs future consensus-building and education.

A cross-sectional, international online survey was distributed to healthcare professionals involved in the care of patients following rectal cancer surgery. The survey assessed awareness of LARS, use of validated diagnostic tools, treatment approaches, access to multidisciplinary services and availability of advanced therapeutic options. Responses were analysed descriptively.

A total of 238 healthcare professionals from 46 countries participated; most were surgeons (79.0%). While 86.6% reported informing patients about LARS risk, only 17.6% reported using POLARS score. Access to specialized services such as pelvic floor physiotherapy or multidisciplinary support varied widely. Initial management commonly included dietary modifications (81.1%) and antidiarrhoeal medications (73.5%), while advanced therapies, such as pelvic floor physical therapy (41.6%), transanal irrigation (32.8%) and sacral neuromodulation (28.6%), were unavailable or underutilized.

Global inconsistencies in LARS care highlight the need for provider education, standardized pathways, wider use of validated tools and improved access to multidisciplinary interventions. Involving patient representatives will be essential to ensure consensus reflects patient priorities and optimizes quality of life.

This study provides the most comprehensive contemporary global overview of Low Anterior Resection Syndrome care, capturing real-world variation in awareness, assessment, management and resource access across 46 countries and identifying critical gaps to inform international consensus, education and equitable survivorship care.