Ali Bohlok1, Camille Mercier1, Fikri Bouazza1, Maria Gomez Galdon2, Luigi Moretti3, Vincent Donckier1, Issam El Nakadi1, Gabriel Liberale4. 1. Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 2. Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 3. Department of Radiation Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 4. Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. Gabriel.liberale@bordet.be.
Abstract
BACKGROUND: Low anterior resection (LAR) with total mesorectal excision (TME) for mid and low rectal cancer is standard of care, reducing local recurrence and enhancing long-term survival. However, this surgery is associated with a constellation of major defecatory problems that are collectively referred to as low anterior resection syndrome (LARS). The aims of this study were to evaluate the frequency of LARS in patients who have undergone LAR and to assess the impact of LARS on long-term quality of life (QoL). METHODS: This was a single-center prospective survey study on patients who underwent LAR and TME for low or mid rectal cancer between 2007 and 2015. LARS score and QLQ-C30 questionnaires were used to evaluate patient's bowel functions and quality of life, respectively. Associations between LARS and QoL were evaluated. RESULTS: Fifty-seven patients out of 65 eligible agreed to participate in the study. Forty-three (66%) patients returned complete questionnaires. Five patients (11.6%) had no LARS, 7 had minor LARS (16.3%), and 31 had major LARS (72.1%). In univariate analysis, BMI > 30 kg/m2 was predictive of major LARS (p = 0.047). Major LARS did not impair global QoL (p = 0.75), function scores, or social scales, and was not associated with any of the symptom scores except for diarrhea (p = 0.02). CONCLUSION: LARS is a frequent occurrence after LAR and TME for rectal cancer (72.1%) and is more prevalent in morbidly obese patients. However, the occurrence of LARS does not appear to have a direct impact on QoL except for the occurrence of diarrhea.
BACKGROUND: Low anterior resection (LAR) with total mesorectal excision (TME) for mid and low rectal cancer is standard of care, reducing local recurrence and enhancing long-term survival. However, this surgery is associated with a constellation of major defecatory problems that are collectively referred to as low anterior resection syndrome (LARS). The aims of this study were to evaluate the frequency of LARS in patients who have undergone LAR and to assess the impact of LARS on long-term quality of life (QoL). METHODS: This was a single-center prospective survey study on patients who underwent LAR and TME for low or mid rectal cancer between 2007 and 2015. LARS score and QLQ-C30 questionnaires were used to evaluate patient's bowel functions and quality of life, respectively. Associations between LARS and QoL were evaluated. RESULTS: Fifty-seven patients out of 65 eligible agreed to participate in the study. Forty-three (66%) patients returned complete questionnaires. Five patients (11.6%) had no LARS, 7 had minor LARS (16.3%), and 31 had major LARS (72.1%). In univariate analysis, BMI > 30 kg/m2 was predictive of major LARS (p = 0.047). Major LARS did not impair global QoL (p = 0.75), function scores, or social scales, and was not associated with any of the symptom scores except for diarrhea (p = 0.02). CONCLUSION: LARS is a frequent occurrence after LAR and TME for rectal cancer (72.1%) and is more prevalent in morbidly obesepatients. However, the occurrence of LARS does not appear to have a direct impact on QoL except for the occurrence of diarrhea.
Entities:
Keywords:
Diarrhea; Low and mid rectal cancer; Low anterior resection syndrome; Major LARS; Quality of life
Authors: Alberto Carrillo; José María Enríquez-Navascués; Araceli Rodríguez; Carlos Placer; José Antonio Múgica; Yolanda Saralegui; Ander Timoteo; Nerea Borda Journal: Cir Esp Date: 2016-01-13 Impact factor: 1.653
Authors: Seung-Seop Yeom; In Ja Park; Sung Woo Jung; Se Heon Oh; Jong Lyul Lee; Yong Sik Yoon; Chan Wook Kim; Seok-Byung Lim; Nayoung Kim; Chang Sik Yu; Jin Cheon Kim Journal: Medicine (Baltimore) Date: 2017-10 Impact factor: 1.889