Θεοδώρου Δημήτριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Τούτουζας Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Θεοδωρόπουλος Γεώργιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Introduction: The progress in surgical technique and in adjuvant and neo-adjuvant therapy has led to an increase in sphincter-preserving surgery in patients with rectal cancer. As a result, more patients experience a wide spectrum of symptoms concerning postoperative defecation impairment; the Low Anterior Resection Syndrome (LARS).
Purpose: Assessment of the risk factors for the LARS in a sample of Greek patients with rectal cancer who have undergone sphincter-preserving surgery, and evaluation of the incidence of the syndrome.
Material-Method: A retrospective, univariate and multivariate analysis of the following, under investigation, risk factors, using the Low Anterior Resection Syndrome Score (LARS-score) questionnaire: sex, age, body mass index, preoperative symptoms, tumor distance, TNM, stage, neo-adjuvant/adjuvant therapy, surgical approach, anastomosis height, anastomosis type, stoma, stoma diversion and post-operative complications.
Outcome: The incidence of LARS is 48.3% in the sample of 120 patients. A high LARS-score was associated with the following factors: tumor distance (p=0,001), type of adjuvant therapy (p=0,003), radiation (p=0,001), type of anastomosis (p=0,001), 'stoma closure interval' (p=0,003) and 'height of anastomosis' (p=0,001). Specifically, tumor distance <5cm (73,2%), adjuvant chemotherapy and radiotherapy (73,1%), radiation (68,2%), colorectal anastomosis (78,6%), stoma closure interval (median=7 months) and low anastomosis height (median=3cm) were associated with a high LARS-score.
Conclusions: The results are similar to those of recent international studies which use the LARS-score as a tool for detecting LARS. The study contributes to the global literature on the investigation of risk factors for LARS.
Rectal cancer, Sphincter-saving surgery, Low anterior resection syndrome, Risk factors, LARS-score questionnaire