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Perioperative radiotherapy is an independent risk factor for major LARS: a cross-sectional observational study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Sphincter-preserving surgery for rectal cancer is often associated with low anterior resection syndrome (LARS). The aim of our study was to determine the prevalence of LARS in our institution and identify possible risk factors for LARS. Furthermore, we evaluated which of the LARS symptoms was considered most disabling by patients and whether or not there is an adaptation of the LARS score over time.

Methods

This study includes a prospective database of 100 patients who underwent total or partial mesorectal excision between January 2009 and September 2014. Patients were contacted after a median postoperative time of 38 (5–45) months to determine the LARS score and to identify LARS symptoms that were considered most disabling. Uni- and multivariate regression analysis was performed to identify risk factors for LARS and major LARS. Finally, the LARS score was evaluated over time after restoration of bowel continuity.

Results

Out of the 100 patients, 16 had minor LARS (score 21–29) and 51 patients had major LARS (score 30–42). Radiotherapy was an independent risk factor for major LARS (p = 0.04). For the majority of patients with major LARS (22%), fragmentation was considered the most disabling complaint. There was no correlation between interval after restoration of bowel continuity and the severity of the LARS score.

Conclusions

Perioperative radiotherapy is an independent risk factor for major LARS. Fragmentation is considered the most disabling complaint in the majority of patients with major LARS. There is no significant adaptation of the LARS score over time.

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Author information

Authors and Affiliations

  1. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium

    Frederiek Nuytens & Mathieu D’Hondt

  2. Faculty of Medicine, KU Leuven, Leuven, Belgium

    Dries Develtere

  3. Department of Abdominal and Hepatobiliary Surgery, Jessa Hospital, Hasselt, Belgium

    Gregory Sergeant

  4. Department of Oncology and Statistics, Groeninge Hospital, Kortrijk, Belgium

    Isabelle Parmentier

  5. Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium

    André D’Hoore

Authors
  1. Frederiek Nuytens
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  2. Dries Develtere
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  3. Gregory Sergeant
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  4. Isabelle Parmentier
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  5. André D’Hoore
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  6. Mathieu D’Hondt
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Contributions

All of the authors meet the ICMJE authorship criteria, with the following specified contributions:

1. Dr. Frederiek Nuytens: study design, data acquisition, and data interpretation

2. Dr. Dries Develtere: data acquisition and data interpretation

3. Prof. Dr. Gregory Sergeant: data analysis

4. Ms. Isabelle Parmentier: data analysis

5. Prof. Dr. André D’Hoore: data interpretation

6. Dr. Mathieu D’Hondt: study design and data interpretation

Corresponding author

Correspondence to Mathieu D’Hondt.

Ethics declarations

This study protocol was approved by the ethics committee at the investigational site (B396201524309).

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

This study has been partially presented as a poster during the free poster sessions of the ESCP conference in Dublin, 23–25 September 2015.

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Nuytens, F., Develtere, D., Sergeant, G. et al. Perioperative radiotherapy is an independent risk factor for major LARS: a cross-sectional observational study. Int J Colorectal Dis 33, 1063–1069 (2018). https://doi.org/10.1007/s00384-018-3043-5

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  • DOI: https://doi.org/10.1007/s00384-018-3043-5

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