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Factors associated with low anterior resection syndrome after surgical treatment of rectal cancer
Author(s) -
JimenezGomez L. M.,
EspinBasany E.,
Trenti L.,
MartíGallostra M.,
SánchezGarcía J. L.,
VallriberaValls F.,
Kreisler E.,
Biondo S.,
ArmengolCarrasco M.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13901
Subject(s) - medicine , total mesorectal excision , odds ratio , colorectal cancer , univariate analysis , radiation therapy , surgery , confidence interval , ileostomy , multivariate analysis , abdominoperineal resection , cancer
Aim The aim was to assess factors independently associated with low anterior resection syndrome (LARS) following resection for rectal cancer. Method This was a cross‐sectional study carried out in two acute‐care teaching hospitals in Barcelona, Spain. Patients who had undergone sphincter‐preserving low anterior resection with curative intent with total or partial mesorectal excision (with and without protective ileostomy) between January 2001 and December 2009 completed a self‐administered questionnaire to assess bowel dysfunction after rectal cancer surgery. Predictors of LARS were assessed by univariate and multivariate analyses. Results The questionnaire was sent to 329 patients (response rate 57.7%). Six cases of incomplete questionnaires were excluded. The study population included 184 patients (66.8% men) with a mean age of 63 years. There were 44 (23.9%) patients with no LARS, 36 (19.6%) with minor LARS and 104 (56.2%) with major LARS. In the univariate analysis, total mesorectal excision ( P = 0.0008), protective ileostomy ( P = 0.002), preoperative and postoperative radiotherapy ( P = 0.0000), postoperative chemotherapy ( P = 0.0046) and age ( P = 0.035) were significantly associated with major LARS, whereas in the multivariate analysis total mesorectal excision (OR 2.18, 95% CI: 1.02–4.65), preoperative radiotherapy (OR 4.33, 95% CI: 2.03–9.27) and postoperative radiotherapy (OR 9.52, 95% CI: 1.74–52.24) were independent risk factors for major LARS. Conclusions In this study, the risk of having major LARS increases with total mesorectal excision and both neoadjuvant and adjuvant radiotherapy.