Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Low anterior resection syndrome (LARS) is a condition of anorectal dysfunction that occurs frequently following anal sphincter-preserving surgery for rectal cancer and can reduce the quality of life. In this review, we summarize the main sy...
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| Format: | Article |
| Language: | English |
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Ewha Womans University College of Medicine
2022-10-01
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| Series: | The Ewha Medical Journal |
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| Online Access: | http://www.e-emj.org/archive/view_article?pid=emj-45-4-12 |
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| author | Seung Mi Yeo Gyung Mo Son |
| author_facet | Seung Mi Yeo Gyung Mo Son |
| author_sort | Seung Mi Yeo |
| collection | DOAJ |
| description | Low anterior resection syndrome (LARS) is a condition of anorectal dysfunction
that occurs frequently following anal sphincter-preserving surgery for rectal
cancer and can reduce the quality of life. In this review, we summarize the main
symptoms and pathophysiology of this syndrome and discuss the treatment
approaches. Early evaluation and initiation of appropriate treatment
postoperatively are crucial. The most frequently used tool to evaluate the
severity of LARS is the LARS score, and an anorectal manometer is used for
objective evaluation. LARS is believed to be caused by multiple factors, and
some of its causes include direct structural damage to the anal sphincter,
damage to the innervation, loss of rectoanal inhibitory reflex, and decreased
rectal volume and compliance. Diet modifications, medications, pelvic floor
muscle training and biofeedback are the primary treatments, and rectal
irrigation can be added as a secondary treatment. If LARS symptoms persist even
after 1 to 2 years and significantly reduce the quality of life, antegrade
irrigation, sacral nerve stimulation or definitive stoma may be considered.
High-quality evidence-based studies on LARS treatment are lacking, and
randomized controlled trials aimed at developing severity-based treatment
algorithms are needed. |
| format | Article |
| id | doaj-art-2c8a94a128cf4016896864227f86efe3 |
| institution | OA Journals |
| issn | 2234-2591 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | Ewha Womans University College of Medicine |
| record_format | Article |
| series | The Ewha Medical Journal |
| spelling | doaj-art-2c8a94a128cf4016896864227f86efe32025-08-20T02:36:19ZengEwha Womans University College of MedicineThe Ewha Medical Journal2234-25912022-10-0145410.12771/emj.2022.e12emj-45-4-12Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current ManagementSeung Mi YeoGyung Mo SonLow anterior resection syndrome (LARS) is a condition of anorectal dysfunction that occurs frequently following anal sphincter-preserving surgery for rectal cancer and can reduce the quality of life. In this review, we summarize the main symptoms and pathophysiology of this syndrome and discuss the treatment approaches. Early evaluation and initiation of appropriate treatment postoperatively are crucial. The most frequently used tool to evaluate the severity of LARS is the LARS score, and an anorectal manometer is used for objective evaluation. LARS is believed to be caused by multiple factors, and some of its causes include direct structural damage to the anal sphincter, damage to the innervation, loss of rectoanal inhibitory reflex, and decreased rectal volume and compliance. Diet modifications, medications, pelvic floor muscle training and biofeedback are the primary treatments, and rectal irrigation can be added as a secondary treatment. If LARS symptoms persist even after 1 to 2 years and significantly reduce the quality of life, antegrade irrigation, sacral nerve stimulation or definitive stoma may be considered. High-quality evidence-based studies on LARS treatment are lacking, and randomized controlled trials aimed at developing severity-based treatment algorithms are needed.http://www.e-emj.org/archive/view_article?pid=emj-45-4-12low anterior resection syndromefecal incontinencerectal neoplasmsrehabilitation |
| spellingShingle | Seung Mi Yeo Gyung Mo Son Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management The Ewha Medical Journal low anterior resection syndrome fecal incontinence rectal neoplasms rehabilitation |
| title | Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and
Current Management |
| title_full | Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and
Current Management |
| title_fullStr | Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and
Current Management |
| title_full_unstemmed | Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and
Current Management |
| title_short | Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and
Current Management |
| title_sort | low anterior resection syndrome pathophysiology risk factors and current management |
| topic | low anterior resection syndrome fecal incontinence rectal neoplasms rehabilitation |
| url | http://www.e-emj.org/archive/view_article?pid=emj-45-4-12 |
| work_keys_str_mv | AT seungmiyeo lowanteriorresectionsyndromepathophysiologyriskfactorsandcurrentmanagement AT gyungmoson lowanteriorresectionsyndromepathophysiologyriskfactorsandcurrentmanagement |