What you should know about the low anterior resection syndrome – Clinical recommendations from a patient perspective

Heijden, J. Van Der; Thomas, Gwendolyn A.; Caers, F.; Dijk, W.A. van; Slooter, Gerrit D.; Maaskant‐Braat, A. J. G.

doi:10.1016/j.ejso.2018.05.010

Cited by 39 publications

(48 citation statements)

References 28 publications

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“…It is difficult to distinguish bacterial contamination and CDI, but two patients expired from septic shock due to severe colitis. Recent CDI treatment guidelines [11,12] defines three times of unformed stool a day as a criterion for CDI diagnosis [13][14][15][16]. In this study, although RG showed about one day of a diagnostic delay than CG, most of CDIs could be diagnosed in early disease period, and the treatment outcomes were also favorable.…”

Section: Discussionmentioning

confidence: 67%

The diagnostic delay and treatment outcome of <i>Clostridium difficile</i> infection in the patients who underwent rectal surgery

Lee¹,

Yeom²,

Lee

et al. 2019

Korean J Clin Oncol

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Section: Discussionmentioning

confidence: 67%

The diagnostic delay and treatment outcome of <i>Clostridium difficile</i> infection in the patients who underwent rectal surgery

Lee¹,

Yeom²,

Lee

et al. 2019

Korean J Clin Oncol

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“…Information dedicated to patients and relatives on websites of colorectal clinics about LARS is lacking important content and material is too complex to understand [ 208 ]. Patients experience a lack of supportive care after surgery for functional complaints and do not know who to counsel [ 209 ]. With regard to a patient’s empowerment surgeons should provide more practical and readily available information on dysfunction after AR and promptly refer patients to their pelvic floor unit for counselling and therapy.…”

Section: Discussionmentioning

confidence: 99%

Optimising functional outcomes in rectal cancer surgery

Nocera¹,

Angehrn²,

Flüe³

et al. 2020

Langenbecks Arch Surg

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Background By improved surgical technique such as total mesorectal excision (TME), multimodal treatment and advances in imaging survival and an increased rate of sphincter preservation have been achieved in rectal cancer surgery. Minimal-invasive approaches such as laparoscopic, robotic and transanal-TME (ta-TME) enhance recovery after surgery. Nevertheless, disorders of bowel, anorectal and urogenital function are still common and need attention. Purpose This review aims at exploring the causes of dysfunction after anterior resection (AR) and the accordingly preventive strategies. Furthermore, the indication for low AR in the light of functional outcome is discussed. The last therapeutic strategies to deal with bowel, anorectal, and urogenital disorders are depicted. Conclusion Functional disorders after rectal cancer surgery are frequent and underestimated. More evidence is needed to define an indication for non-operative management or local excision as alternatives to AR. The decision for restorative resection should be made in consideration of the relevant risk factors for dysfunction. In the case of restoration, a side-to-end anastomosis should be the preferred anastomotic technique. Further high-evidence clinical studies are required to clarify the benefit of intraoperative neuromonitoring. While the function of ta-TME seems not to be superior to laparoscopy, case-control studies suggest the benefits of robotic TME mainly in terms of preservation of the urogenital function. Low AR syndrome is treated by stool regulation, pelvic floor therapy, and transanal irrigation. There is good evidence for sacral nerve modulation for incontinence after low AR.

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“…El estudio cualitativo de Van der Heijden et al 41 , tuvo por objetivo dilucidar cómo el LARS afecta la calidad de vida desde la perspectiva del paciente con cáncer rectal para mejorar la estrategia de atención actual. Como resultado se identificaron tres temas principales que se describen en la Tabla 4.…”

Section: Pre-habilitación En Lars Y Calidad De Vidaunclassified

Síndrome de resección anterior baja en pacientes con cáncer de recto medio e inferior ¿Qué más podemos hacer?

Campos¹,

Albornoz

2021

Rev. Cirugia

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Durante las últimas décadas los avances en técnicas quirúrgicas, radioterapia y quimioterapia han logrado de forma significativa aumentar la sobrevida y disminuir la recidiva local en el cáncer de recto evitando una colostomía definitiva; sin embargo, este trascendental progreso médico no ha ido acompañado de una mejoría en los resultados funcionales de los pacientes sometidos a una cirugía conservadora de esfínter, siendo el conjunto de síntomas defecatorios posterior a la resección rectal, conocido como síndrome de resección anterior baja (LARS), una secuela prácticamente inevitable, que generalmente se asocia a disfunción sexual, urinaria, dolor crónico, altos costos en rehabilitación y control sintomático, además de una alteración importante en la calidad de vida. En este artículo presentamos una revisión completa y actualizada de las características clínicas y alternativas de tratamiento del LARS, finalizando con una propuesta de manejo integral multidisciplinario que destaca la importancia de la pre-habilitación, evaluación objetiva de los síntomas, educación e información adecuada del paciente y su familia, además del trabajo en equipo en unidades especializadas de rehabilitación de piso pélvico, requisito fundamental a la hora de manejar adecuadamente esta patología.

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What you should know about the low anterior resection syndrome – Clinical recommendations from a patient perspective

Cited by 39 publications

References 28 publications

The diagnostic delay and treatment outcome of <i>Clostridium difficile</i> infection in the patients who underwent rectal surgery

The diagnostic delay and treatment outcome of <i>Clostridium difficile</i> infection in the patients who underwent rectal surgery

Optimising functional outcomes in rectal cancer surgery

Síndrome de resección anterior baja en pacientes con cáncer de recto medio e inferior ¿Qué más podemos hacer?

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