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

Authors
 Ahmad Sakr  ;  Fozan Sauri  ;  Mohammed Alessa  ;  Eman Zakarnah  ;  Homoud Alawfi  ;  Radwan Torky  ;  Ho Seung Kim  ;  Seung Yoon Yang  ;  Nam Kyu Kim 
Citation
 CHINESE MEDICAL JOURNAL, Vol.133(15) : 1824-1833, 2020-08 
Journal Title
 CHINESE MEDICAL JOURNAL 
ISSN
 0366-6999 
Issue Date
2020-08
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.
Files in This Item:
T202004354.pdf Download
DOI
10.1097/CM9.0000000000000852
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180228
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