scholarly journals A Study on the Clinical Application of Greater Omental Pedicle Flap Transplantation to Correct Anterior Resection Syndrome in Patients With Low Rectal Cancer

2020 ◽  
Author(s):  
haiquan qin ◽  
Linghou Meng ◽  
Zigao Huang ◽  
Jiankun Liao ◽  
Yan Feng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Neoadjuvant Chemoradiotherapy ◽  
Low Rectal Cancer ◽  
Anal Function ◽  
Pedicle Flap ◽  
Anterior Resection Syndrome ◽  
Omental Pedicle Flap

Abstract PurposeLow anterior resection syndrome (LARS) is the most common complication after total mesorectal excision (TME) in patients with low rectal cancer and has been a challenge in colorectal surgery that severely impacts the quality of life of patients. This study aimed to introduce a revised surgical procedure which could effectively maintain rectal compliance and significantly improve LARS after the operation.MethodsWe performed mesorectal reconstruction after routine Dixon-TME using greater omental pedicle flap transplantation in 11 patients with low rectal cancer (5 cases of preoperative neoadjuvant chemoradiotherapy, 5 cases of preoperative neoadjuvant chemotherapy, and 1 case of postoperative adjuvant chemotherapy), thereby simulating the initial anatomical structure of the mesorectum and significantly reducing the postoperative anterior resection syndrome. The lars precision syndrome assessment scale (LARSS) was used to access the LARS.ResultsAt 12 weeks after the 11 patients recovered from the anal defecation function, the average score on the LARS questionnaire was 25.5 ± 0.5 (mild). The average time at which anal function began to recover was 6.2 ± 2.6 weeks after surgery. The recovery was rapid, as the rectal and anal function of all patients generally returned to normal levels within 12 weeks, and the quality of life was close to that before surgery. ConclusionGreater omental flap transplantation can significantly improve LARS after Dixon-TME in patients with low rectal cancer.

The burden of low anterior resection syndrome on quality of life in patients with mid or low rectal cancer

2019 ◽  
Vol 28 (3) ◽  
pp. 1199-1206 ◽  
Author(s):  
Ali Bohlok ◽  
Camille Mercier ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Luigi Moretti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Low Rectal Cancer ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study

2018 ◽  
Vol 44 (7) ◽  
pp. 1031-1039 ◽  
Author(s):  
Loris Trenti ◽  
Ana Galvez ◽  
Sebastiano Biondo ◽  
Alejandro Solis ◽  
Francesc Vallribera-Valls ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Cross Sectional Study ◽  
Low Rectal Cancer ◽  
Sectional Study ◽  
Cross Sectional ◽  
Anterior Resection Syndrome

scholarly journals Quality of Life and Bowel Dysfunction after Transanal Endoscopic Microsurgery for Rectal Cancer: One Third of Patients Experience Major Low Anterior Resection Syndrome

2019 ◽  
Vol 37 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Maarten van Heinsbergen ◽  
Jeroen W. Leijtens ◽  
Gerrit D. Slooter ◽  
Maryska L. Janssen-Heijnen ◽  
Joop L. Konsten
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Bowel Dysfunction ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Endoscopic Microsurgery

Background/Aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three ­patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the ­European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. “Major LARS” was observed in 29% of patients and “minor LARS” in 26%. Female gender (OR 4.00; 95% CI 1.20–13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08–12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01–1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.

Low anterior resection syndrome: impact on quality of life and nurse-led management

2021 ◽  
Vol 19 (Sup4a) ◽  
pp. S15-S20
Author(s):  
Jennie Burch
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Surgical Removal ◽  
Negative Consequences ◽  
Management Options ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

Rectal cancer is common and is often treated with surgical removal of the rectum, potentially including chemoradiation. Despite improvements in surgical technique, this treatment often results in long-term negative consequences. The most common of these symptoms involve bowel dysfunction, such as faecal incontinence, constipation and urgency, and are collectively termed low anterior resection syndrome (LARS). These often negatively impact on quality of life in a number of areas, including work, relationships and mental wellbeing. These symptoms can be eased with conservative management techniques, such as dietary modification, pelvic floor exercises and medication. If these are insufficient, patients can try specialist nurse-led interventions, including biofeedback, hypnotherapy, nerve stimulation and/or transanal irrigation. If these management options do not provide adequate quality of life, a permanent colostomy can be formed. It is important for nurses to recognise that problems can occur after treatment for rectal cancer and assist patients to overcome these problems and improve their quality of life.

scholarly journals Validation of the Low Anterior Resection Syndrome Score in Finnish Patients: Preliminary Results on Quality of Life in Different Lars Severity Groups

2020 ◽  
pp. 145749692093014
Author(s):  
A. Carpelan ◽  
E. Elamo ◽  
J. Karvonen ◽  
P. Varpe ◽  
S. Elamo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Life Questionnaire ◽  
Mesorectal Excision ◽  
Low Anterior Resection Syndrome ◽  
European Organisation ◽  
Anterior Resection Syndrome

Background and Aims: Low anterior resection syndrome is common after anterior resection for rectal cancer. Its severity can be tested with the low anterior resection syndrome score. We have translated the low anterior resection syndrome score to Finnish, and the aim of this study is to validate the translation. Materials and Methods: The translated Finnish low anterior resection syndrome score and European Organisation for Research and Treatment of Cancer quality-of-life questionnaire-C30 and QLQ-CR29 questionnaires were sent to 159 surviving patients operated with anterior resection for rectal adenocarcinoma between 2007 and 2014 in a tertiary referral center. Psychometric properties of the translation were evaluated in comparison to quality-of-life scales and in different risk factor groups. Results: In the study, 104 (65%) patients returned the questionnaires. Of these, 56 (54%) had major low anterior resection syndrome, 26 (25%) had minor low anterior resection syndrome, and 22 (21%) had no low anterior resection syndrome. Patients with major low anterior resection syndrome had a significantly lower quality of life and more defecatory symptoms as assessed with the European Organisation for Research and Treatment of Cancer questionnaires compared with those with no low anterior resection syndrome. Patients operated with total mesorectal excision had significantly higher low anterior resection syndrome scores compared with those operated with partial mesorectal excision (median/interquartile range 32/15 and 29/11, respectively, p = 0.037). The test–retest validity of the translation was good with an intraclass correlation coefficient of 0.77 (95% confidence interval 0.51–0.90). Conclusion: The Finnish low anterior resection syndrome score is a valid test in the assessment of postoperative bowel function and its impact on the quality of life. It can be implemented to use during regular follow-up visits of Finnish-speaking rectal cancer patients.

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