Anterior resection syndrome following sphincter-preserving resection in the UK population
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Published version
Embargoed until: 5555-01-01
Reason: Version Not Permitted
Embargoed until: 5555-01-01
Reason: Version Not Permitted
Editors
Mortensen, NJ
Volume
Suppl 2
Pagination
3 - 12 (10)
Publisher
Publisher URL
DOI
10.1111/codi.13498
Location
Issue
ISSN
1455-8998
Metadata
Show full item recordAbstract
Purpose: Following anterior resection, patients often report variable symptoms of urgency, incontinence, and unpredictable bowel habits – termed ‘Low Anterior Resection Syndrome’ (LARS). LARS has an adverse impact on patients’ quality of life (QoL). This epidemiological study aimed to determine the proportion of patients with LARS in the UK population using the recently validated LARS score. Methods: Nineteen NHS trusts in England and Scotland participated as patient identification centres. Patients who had undergone anterior resection for cancer, more than 12-months previously, were sent the study questionnaires including the LARS score, EORTC QLQ-C30 QoL score, and questions determining eligibility, treatment received and potential risk factors for LARS. Results: The overall response rate was 53%; 1093 patients were included in analysis. 40.9% had major LARS (LARS score ≥30); 21.9% had minor LARS and 37.2% had no LARS. Risk factors for major LARS included neoadjuvant chemoradiotherapy (odds ratio 3.89, 95% confidence interval 2.49 to 6.07), female gender (odds ratio 1.33, 95% confidence interval 1.00 to 1.76) and open surgery (odds ratio 1.38, 95% confidence interval 1.05 to 1.87). QoL scores were significantly lower in those with major LARS. Significant variation was noted between Trusts in the proportion of patients having defunctioning stoma, neoadjuvant and adjuvant therapy, and open/laparoscopic surgery. Conclusions: LARS is a significant complication affecting a large proportion of patients undergoing sphincter-preserving surgery for cancer. Patients undergoing rectal resection should be counselled regarding LARS. Routine use of LARS score during follow-up will help to identify patients, who might benefit from active treatment.