Awareness and management of low anterior resection syndrome: A Dutch national survey among colorectal surgeons and specialized nurses

Thomas, Gwendolyn A.; Heinsbergen, Maarten van; Heijden, J. Van Der; Slooter, Gerrit D.; Konsten, J.; Maaskant, Sabrina

doi:10.1016/j.ejso.2018.11.001

Cited by 22 publications

(14 citation statements)

References 18 publications

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“…Although the majority of the studies focused solely on aspects of fecal incontinence following surgery for colon cancer, we found that patients suffered equally from constipation-associated symptoms. In general, clinicians have the tendency to overestimate the impact of fecal incontinence and underestimate the discomfort of constipation-associated symptoms such as clustering of stools [60,61]. As we found a pooled Wexner score of 1.4, which indicates minimal fecal incontinence [62], it would seem that the combination of different defecation problems, rather than fecal incontinence alone, is what afflicts colon cancer patients following surgery.…”

Section: Discussionmentioning

confidence: 73%

Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis

Verkuijl

Jonker

Trzpis

et al. 2021

European Journal of Surgical Oncology

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Introduction: As survival rates of colon cancer increase, knowledge about functional outcomes is becoming ever more important. The primary aim of this systematic review and meta-analysis was to quantify functional outcomes after surgery for colon cancer. Secondly, we aimed to determine the effect of time to follow-up and type of colectomy on postoperative functional outcomes. Materials and methods: A systematic literature search was performed to identify studies reporting bowel function following surgery for colon cancer. Outcome parameters were bowel function scores and/or prevalence of bowel symptoms. Additionally, the effect of time to follow-up and type of resection was analyzed. Results: In total 26 studies were included, describing bowel function between 3 to 178 months following right hemicolectomy (n ¼ 4207), left hemicolectomy/sigmoid colon resection (n ¼ 4211), and subtotal/ total colectomy (n ¼ 161). In 16 studies (61.5%) a bowel function score was used. Pooled prevalence for liquid and solid stool incontinence was 24.1% and 6.9%, respectively. The most prevalent constipationassociated symptoms were incomplete evacuation and obstructive, difficult emptying (33.3% and 31.4%, respectively). Major Low Anterior Resection Syndrome was present in 21.1%. No differences between time to follow-up or type of colectomy were found. Conclusion: Bowel function problems following surgery for colon cancer are common, show no improvement over time and do not depend on the type of colectomy. Apart from fecal incontinence, constipation-associated symptoms are also highly prevalent. Therefore, more attention should be paid to all possible aspects of bowel dysfunction following surgery for colon cancer and targeted treatment should commence promptly.

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Section: Discussionmentioning

confidence: 73%

Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis

Verkuijl

Jonker

Trzpis

et al. 2021

European Journal of Surgical Oncology

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“…Being cancer free, getting through surgery and dealing with the temporary stoma are the priorities of patients at that time (Park et al, 2014). Another possible reason is the fact that the general knowledge and awareness of LARS is low in HCPs (Thomas et al, 2019). So the impact of LARS on patients' lives can be underestimated (Chen et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

The trajectory of hope and loneliness in rectal cancer survivors with major low anterior resection syndrome: A qualitative study

Pape

Decoene

Debrauwere

et al. 2022

European Journal of Oncology Nursing

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“…Clinicians often underestimate the risk and the impact of functional bowel complaints ( 32 ). However, based on the data in this study it might be suggested that in current clinical practice more attention is paid to functional bowel complaints in the elderly than in the younger population.…”

Section: Discussionmentioning

confidence: 99%

Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly

et al. 2022

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BackgroundThe Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery is unclear. We aimed to describe the prevalence of LARS complaints and the impact on quality of life in the elderly after colorectal cancer surgery.Materials and MethodsPatients were included from seven Dutch hospitals if they were at least one year after they underwent colorectal cancer surgery between 2008 and 2015. Functional bowel complaints were assessed by the LARS score. Quality of life was assessed by the EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires. Outcomes in patients ≥70 years were compared to a reference group of patients <70 years.ResultsIn total 440 rectal cancer and 1183 colon cancer patients were eligible for analyses, of whom 133 (30.2%) rectal and 536 (45.3%) colon cancer patients were ≥70 years. Major LARS was reported by 40.6% of rectal cancer and 22.2% of colon cancer patients ≥70 years. In comparison, patients <70 years reported major LARS in 57.3% after rectal cancer surgery (p=0.001) and in 20.4% after colon cancer surgery (p=0.41). Age ≥70 years was independently associated with reduced rates of major LARS after rectal cancer surgery (OR 0.63, p=0.04). Patients with major LARS reported significantly impaired quality of life on almost all domains.ConclusionElderly should not be withheld a restorative colorectal cancer resection based on age alone. However, a substantial part of the elderly colorectal cancer patients develops major LARS after surgery, which often severely impairs quality of life. Since elderly frequently consider quality of life and functional outcomes as one of the most important outcomes after treatment, major LARS and its impact on quality of life should be incorporated in the decision-making process.

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Awareness and management of low anterior resection syndrome: A Dutch national survey among colorectal surgeons and specialized nurses

Cited by 22 publications

References 18 publications

Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis

Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis

The trajectory of hope and loneliness in rectal cancer survivors with major low anterior resection syndrome: A qualitative study

Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly

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