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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 4/2016

01-04-2016 | Original Article

Low anterior resection syndrome: a survey of the members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP)

Authors: Luis Miguel Jimenez-Gomez, Eloy Espin-Basany, Marc Marti-Gallostra, Jose Luis Sanchez-Garcia, Francesc Vallribera-Valls, Manuel Armengol-Carrasco

Published in: International Journal of Colorectal Disease | Issue 4/2016

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Abstract

Background

Low anterior resection syndrome (LARS) is frequent following sphincter-sparing procedures for rectal cancer.

Objective

This study aims to assess surgeons’ awareness of LARS.

Design

This was a survey study.

Settings

Members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP).

Participants

Three hundred thirty-four surgeons from the ASCRS and 150 from the Spanish Societies completed a 23-item electronic questionnaire.

Main outcome measures

Surgeons’ opinions regarding different aspects of LARS.

Results

The proportion of rectal cancer patients undergoing sphincter-sparing operations ranged between 71 and 90 %. Low anterior resection with end-to-end anastomosis was the most frequently cited procedure after mesorectal excision. More than 80 % of participants were recognized to be moderately or extremely aware of the condition, but regarding the method used to assess LARS, the majority relied on clinical manifestations. Around 35 % of surgeons considered that severe LARS developed in less than 40 % of patients. The most important factor related to defecatory function impairment in the surgeons’ opinion was the distance from the anal margin to anastomosis. Other factors thought to be involved were anastomotic leakage, preoperative radiation therapy, age, and postoperative radiotherapy, with similar percentages in the two groups of surgeons. Lifestyle changes and dietary measures associated with or without drug treatment was the modality of choice. The experience with transanal irrigation or sacral nerve stimulation was limited. It was considered that <30 % of patients chronically suffer from severe LARS with significant quality of life impairment.

Limitations

The limitations of this study are the international mix and expert status of the specialists.

Conclusions

The probability of patients suffering from LARS was underestimated despite reporting good knowledge of the syndrome. Validated methods for the assessment of LARS were rarely used. Deficient awareness regarding risk factors for LARS was documented. Knowledge of therapeutic options was also limited.
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Metadata
Title
Low anterior resection syndrome: a survey of the members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP)
Authors
Luis Miguel Jimenez-Gomez
Eloy Espin-Basany
Marc Marti-Gallostra
Jose Luis Sanchez-Garcia
Francesc Vallribera-Valls
Manuel Armengol-Carrasco
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 4/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-016-2511-z

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