Department of Nursing, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Sun Yat- sen University, Tianhe Road 600, 510630, Guangzhou, China.
BMC Surg. 2023 May 6;23(1):110. doi: 10.1186/s12893-023-02008-4.
The incidence and risk factors of low anterior resection syndrome (LARS) largely variate in different studies. In addition, there is lack of study on how patients evaluate the therapeutic effect of LARS. This single-center retrospective study aims to investigate the status of LARS in Chinese patients undergoing laparoscopic low anterior resection (LAR).
Consequent patients undergoing laparoscopic LAR and free from disease recurrence from January 2015 to May 2021 were issued with both LARS questionnaire and satisfaction survey. Related data were collected and analyzed.
Both LARS questionnaires and self-made satisfaction survey were received from 261 eligible patients. The overall incidence of LARS was 47.1% (minor in 19.5%, major in 27.6%), decreased with the passage of postoperative time (64.7% within 12 months, and 41.7% within 12-36 months), and became stable 36 months later (39.7%). The most common symptoms were defecation clustering (n = 107/261, 41.0%) and defecation urgency (n = 101/261, 38.7%). According to the multivariable regression analysis, risk factors of major LARS were: 1 year increase in age (OR 1.035, 95% CI 1.004-1.068), protective stoma (OR 2.656, 95% CI 1.233-5.724) and T stage (OR 2.449, 95% CI 1.137-5.273). Most patients complained defecation disorder (87.3%) to doctors and 84.5% got suggestions or treatments for it. However, only 36.8% patients thought the treatments worked for them.
LARS frequently occurs after laparoscopic LAR, while the therapeutic effect is not satisfying. Elder, advanced T-stage and protective stoma were risk factors for postoperative major LARS.
低位前切除综合征（LARS）的发生率和危险因素在不同的研究中差异很大。此外，对于患者如何评估 LARS 的治疗效果，目前还缺乏研究。本单中心回顾性研究旨在调查腹腔镜低位前切除术（LAR）后中国患者的 LARS 状况。
连续收集 2015 年 1 月至 2021 年 5 月接受腹腔镜 LAR 且无疾病复发的患者，发放 LARS 问卷和满意度调查。收集并分析相关数据。
共纳入 261 例符合条件的患者，均收到 LARS 问卷和自制满意度调查。LARS 的总发生率为 47.1%（轻度为 19.5%，重度为 27.6%），随术后时间的推移而降低（12 个月内为 64.7%，12-36 个月内为 41.7%），36 个月后趋于稳定（39.7%）。最常见的症状是排便聚集（n=261，41.0%）和排便急迫（n=261，38.7%）。多变量回归分析显示，LARS 严重程度的危险因素为：年龄增加 1 年（OR 1.035，95%CI 1.004-1.068）、保护性造口（OR 2.656，95%CI 1.233-5.724）和 T 分期（OR 2.449，95%CI 1.137-5.273）。大多数患者向医生抱怨排便障碍（87.3%），并得到了建议或治疗。然而，只有 36.8%的患者认为治疗对他们有效。
腹腔镜 LAR 后 LARS 频繁发生，治疗效果不理想。年龄较大、T 分期较高和保护性造口是术后发生严重 LARS 的危险因素。
