Annals of Coloproctology

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Original Article

Anorectal physioloy

Risk factors associated with low anterior resection syndrome: a cross-sectional study: See Liang Lim, Wan Zainira Wan Zain, Zalina Zahari, Andee Dzulkarnaen Zakaria, Mohd Nizam Md Hashim, Michael Pak-Kai Wong, Zaidi Zakaria, Rosnelifaizur Ramely, Ahmad Shanwani Mohamed Sidek; Ann Coloproctol. 2023;39(5):427-434. Published online June 3, 2022; DOI: https://doi.org/10.3393/ac.2022.00227.0032

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Purpose
Oncological outcomes following rectal cancer surgery have improved significantly over recent decades with lower recurrences and longer overall survival. However, many of the patients experienced low anterior resection syndrome (LARS). This study identified the prevalence and risk factors associated with the development of LARS.
Methods
This cross-sectional study involved patients who were diagnosed with rectal cancer and had undergone sphincter-preserving low anterior resection from January 2011 to December 2020. Upon clinic follow-up, patients were asked to complete an interviewed based questionnaire (LARS score) designed to assess bowel dysfunction after rectal cancer surgery.
Results
Out of 76 patients, 25 patients (32.9%) had major LARS, 10 patients (13.2%) had minor LARS, and 41 patients (53.9%) had no LARS. The height of tumor from anal verge showed an association with the development of major LARS (P=0.039). Those patients with less than 8 cm tumor from anal verge had an increased risk of LARS by 3 times compared to those with 8 cm and above (adjusted odds ratio, 3.11; 95% confidence interval, 1.06–9.13).
Conclusion
Results from our study show that low tumor height was a significant risk factor that has a negative impact on bowel function after surgery. The high prevalence of LARS emphasizes the need for study regarding risk factors and the importance of understanding the pathophysiology of LARS, in order for us to improve patient bowel function and quality of life after rectal cancer surgery.

Citations

Citations to this article as recorded by

Longitudinal evolution of low anterior resection syndrome in ultra-low rectal cancer: A trend analysis of a propensity-matched cohort
Han-Shuo Wang, Yu-Xin Lin, Si-Rui Xu, Li-Ya Wang, Xiao-Dong Wang, Ming-Jun Huang
World Journal of Gastroenterology.2026;[Epub] CrossRef
Score assessment and treatment in patients presenting with low anterior resection syndrome after sphincter-sparing rectal cancer surgery
R. Sguinzi, J. Fiechter, L. Bafumi, B. Gremaud, B. Geng, P. Janiak, L. Bühler, B. Egger
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npj Digital Medicine.2025;[Epub] CrossRef
Impact of low anterior resection syndrome after rectal surgery on sleep quality
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Annals of Coloproctology.2025; 41(4): 303. CrossRef
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International Journal of Colorectal Disease.2024;[Epub] CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
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