Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands.
Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands.
Colorectal Dis. 2020 Jan;22(1):46-52. doi: 10.1111/codi.14790. Epub 2019 Aug 21.
The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after colorectal cancer surgery. There are no data about these complaints and the association with QoL in a reference population. The aim of this study was to assess LARS and the association with QoL in a reference population.
Six hundred patients who visited the outpatient clinic because of general or trauma surgical indications were asked to participate in this study. They received an invitation letter containing three validated questionnaires to assess LARS (assessed with the LARS score) and both general [European Organization for the Research and Treatment of Cancer (EORTC) QLQ-C30] and colorectal-specific (EORTC QLQ-CR29) QoL.
Five hundred and one respondents could be included for the analyses. The median age at inclusion was 68 years and 47.3% were men. Major LARS was observed in 15% of patients (11.4% in men and 18.9% in women, P = 0.021). Women reported more urgency (P = 0.070) and incontinence for both flatus (P < 0.001) and stool (P = 0.063) compared to men. In univariate analyses, women reported major LARS significantly more often than men (OR 1.82; 95% CI 1.10-3.01). Patients with major LARS scored significantly worse in most QoL domains compared to patients with no/minor LARS.
This is the first study demonstrating major LARS and the association with QoL in a reference population of patients without colorectal cancer. Our data can assist in the interpretation of LARS in past and future research about abdominal complaints after colorectal cancer surgery.
低位前切除综合征(LARS)严重影响结直肠癌手术后的生活质量(QoL)。目前尚无关于这些投诉以及与参考人群中 QoL 相关的资料。本研究旨在评估参考人群中 LARS 及其与 QoL 的相关性。
600 名因普通或创伤外科指征就诊的门诊患者被邀请参加这项研究。他们收到了一封邀请信,其中包含三个经过验证的问卷,用于评估 LARS(通过 LARS 评分评估)以及一般(欧洲癌症研究与治疗组织(EORTC)QLQ-C30)和结直肠特异性(EORTC QLQ-CR29)的 QoL。
501 名受访者可进行分析。纳入时的中位年龄为 68 岁,47.3%为男性。15%的患者存在主要 LARS(男性为 11.4%,女性为 18.9%,P=0.021)。与男性相比,女性报告更多的急迫感(P=0.070)和粪便失禁(P<0.001)和放屁(P=0.063)。在单变量分析中,女性报告的主要 LARS 明显多于男性(OR 1.82;95%CI 1.10-3.01)。与无/轻度 LARS 患者相比,存在主要 LARS 的患者在大多数 QoL 领域的评分明显更差。
这是第一项在没有结直肠癌的参考人群中研究主要 LARS 及其与 QoL 相关性的研究。我们的数据可以帮助解释过去和未来结直肠癌手术后腹部不适的研究中 LARS 的结果。