Awareness and Knowledge of Low Anterior Resection Syndrome (Lars) in Colorectal Surgeons: A Cross-sectional Survey

Abstract

Background More than 50% patients suffered from low anterior resection syndrome (LARS) after low anterior resection, and their quality of life is predominantly determined by colorectal surgeons’ awareness and knowledge of LARS. We conducted the survey to find out the weakness in the management of patients' functional recovery after surgery and explore targeted training pathways to improve doctor’s ability to deal with LARS. Methods An anonymous paper-based survey among colorectal surgeons was performed across the country. Results 252 questionnaires were collected and analyzed with the effective rate of 86.6%. Most of the respondents were highly educated and experienced in gastroenterology. The mean age was 39.9 ± 9.20 years. In multivariate Logistic regression analysis, surgeons with MD, PhD degree (OR: 2.843, 95%CI: 1.441-5.609, p = 0.003) and national academic membership (OR: 2.063, 95%CI: 1.010-4.214, p = 0.047) were associated with surgeons’ emphasis on follow-up. 65.1% of respondents underestimated the prevalence of LARS. Chief/deputy chief, national academic membership and annual surgeries ≥ 50 (42.7% vs 29.4%, p=0.033; 46.4% vs 30.0%, p=0.007; 46.0% vs 31.6%, p=0.021) were associated with high diagnostic rate of LARS but none of these factors were statistically significant in multivariate analysis. LARS score was the most popular scale in the evaluation of LARS severity. The feedback of the most common postoperative anorectal disorders by colorectal surgeons was significantly different from the items listed in the LARS score. 48.4% of respondents use drugs to treat LARS but therapies varied from surgeons to surgeons. Conclusions There is a lack of knowledge relating to LARS in colorectal surgeons. Clinical guidelines should be developed to guide medical staff in effective management of patients with LARS.