Assessment and management of low anterior resection syndrome after sphincter preserving surgery for rectal cancer

Ahmad Sakr, Fozan Sauri, Mohammed Alessa, Eman Zakarnah, Homoud Alawfi, Radwan Torky, Ho Seung Kim, Seung Yoon Yang, Nam Kyu Kim

Research output: Contribution to journalArticle

Abstract

Many patients develop a variety of bowel dysfunction after sphincter preserving surgeries (SPS) for rectal cancer. The bowel dysfunction usually manifests in the form of low anterior resection syndrome (LARS), which has a negative impact on the patients' quality of life. This study reviewed the LARS after SPS, its mechanism, risk factors, diagnosis, prevention, and treatment based on previously published studies. Adequate history taking, physical examination of the patients, using validated questionnaires and other diagnostic tools are important for assessment of LARS severity. Treatment of LARS should be tailored to each patient. Multimodal therapy is usually needed for patients with major LARS with acceptable results. The treatment includes conservative management in the form of medical, pelvic floor rehabilitation and transanal irrigation and invasive procedures including neuromodulation. If this treatment failed, fecal diversion may be needed. In conclusion, Initial meticulous dissection with preservation of nerves and creation of a neorectal reservoir during anastomosis and proper Kegel exercise of the anal sphincter can minimize the occurrence of LARS. Pre-treatment counseling is an essential step for patients who have risk factors for developing LARS.

Original languageEnglish
Pages (from-to)1824-1833
Number of pages10
JournalChinese Medical Journal
Volume133
Issue number15
DOIs
Publication statusPublished - 2020 Aug 5

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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