Study aimed to assess long-term bowel function in patients who underwent low anterior resection for cancer five and more years ago. Patients who underwent low anterior resection for rectal cancer from 2010 to 2015 at National Cancer Institute were prospectively included in our study. They were interviewed using low anterior resection syndrome (LARS) score and Wexner questionnaire. We also assessed possible risk factors of postoperative bowel disorder. 150 patients were included in our study. Of them 125 (83.3%) were analysed. The median age at diagnosis was 62 years (40-79), and the average time of follow-up was 7.5 years (5-11). Overall, 58 (46.4%) patients had LARS, of them 33 (26.4%)-major LARS and 25 (20%)-minor LARS and 67 (53.6%) reported no LARS. Wexner score results were: normal in 43 (34.4%) patients, minor faecal incontinence-55 (44%), average faecal incontinence-18 (14.4%), complete faecal incontinence-9 (7.2%). 51 patients (40.8%) had tumour in the upper third rectum, 51 (40.8%)-in the middle and 23 (18.4%)-lower third. Preoperative (chemo) radiotherapy was the only significant risk factors for developing LARS in univariate analysis. Our study showed that only preoperative radiotherapy may be associated with more late problems in defecation after rectal cancer surgery. Trial registration: NCT03920202. Rectal cancer (RC) is a frequent and fatal disease with high incidence rate in developed countries, possibly because of differences in environment and diet 1. The age standardized incidence rate among men and women in Europe, was 15-25/100.000 new cases of RC per year with a range of mortality from four to 10/100.000 2. For the last almost 30 years, the gold standard treatment for RC is low anterior resection (LAR) with total mesorectal excision (TME) as described by Heald 3. Unfortunately, up to 80% of patients undergoing LAR will suffer of bowel dysfunction including faecal urgency, frequent bowel movements, tenesmus or so called Low Anterior Resection Syndrome (LARS) 4. Simply it has been defined as "disordered bowel function after rectal resection, leading to a detriment in quality of life" 4. Same year LARS score was developed 5. This tool is easy to use and has been internationally and in Lithuania validated 6,7. Wexner score is another tool for evaluation of faecal continence 8. Recently Delphi consensus on LARS description was published. To meet the definition, a patient must have had an anterior resection (sphincterpreserving rectal resection) and experience at least 1 of suggested 8 symptoms that result in at least one of suggested 8 consequences 9. The advantaged of the Delphi approach is that unlike most patient-reported outcome measures that were initially produced by expert clinician researchers who then consulted patient populations, the Delphi definition of LARS actively involved all major stakeholders, especially patients, early in the construction to ensure that the resulting tool was fit for purpose. To our knowledge there are only five studies investigating long-term LARS following re...

Background: Our aim was to compare the bowel function and oncologic outcomes following these two treatment modalities.Materials and methods: This was a single-center study with 67 patients included between 2009 and 2018. A total of 32 patients underwent total mesorectal excision (TME) group and 35 transanal local excisions (LE) ± chemoradiation. We performed a case-matched analysis: we matched the patients by age, cancer stage, and comorbidities. Duration of operation, postoperative complications, length of hospital stay, and long-term functional and oncological outcomes were compared. We calculated oncological outcomes using Kaplan–Meier Cox diagrams. In addition, we used a low anterior resection syndrome (LARS) score for the bowel function assessment.Results: Mean operation time in the LE group was 58.8 ± 45 min compared with the TME group that was 121.1 ± 42 min (p = 0.032). Complications were seen in 5.7% in LE group and 15.62% in TME group (p = 0.043). ~85.2% of the patients had no LARS in LE group compared with 54.5% in TME group (p = 0.018). Minor LARS was 7.4% in LE group compared with 31.8% in TME group (p = 0.018); major LARS was 7.4 and 13.7%, respectively (p = 0.474). Hospital stay was 2.77 days in LE group compared with 9.21 days in TME group (p = 0.036). The overall survival was 68.78 months in LE group compared with 74.81 months in TME group (p = 0.964).Conclusion: Our results of a small sample size showed that local excision ± chemoradiation is a rather safe method for early rectal cancer compared with gold standard treatment. In addition, better bowel function is preserved with less postoperative complications and shorter hospital stays.