Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.
Department of Emergency Medicine, Western University, London, Ontario, Canada.
Colorectal Dis. 2023 Sep;25(9):1812-1820. doi: 10.1111/codi.16665. Epub 2023 Jul 27.
Restorative proctectomy is commonly associated with significant bowel dysfunction, known as low anterior resection syndrome (LARS), which has a negative impact on patients' quality of life. We developed an online patient-centred application on LARS (eLARS) for rectal cancer survivors. The primary objective of this study was to assess the feasibility of eLARS for rectal cancer survivors with LARS following restorative proctectomy. The secondary objective was to explore participants' experiences with LARS and the eLARS application.
This was a mixed methods study, which included a feasibility and qualitative analysis. Participants were rectal cancer survivors who underwent restorative proctectomy for rectal cancer within 3 years, completed all adjuvant treatment, and suffered from bowel dysfunction postoperatively. Participants were given access to the application over a 2-month study period. Feasibility was defined as 75% of study participants using the application ≥4 times per month. Semi-structured interviews were conducted with participants after the study period and were analysed using thematic analysis.
Our sample included eight rectal cancer survivors, five women and three men. The median age was 58.5 years (56.5-64.5). Most participants (75%) were >1-year post-restorative proctectomy. 75% of study participants used the application ≥4 times per month for 2 months. Our thematic analysis revealed that participants felt that they lacked access to credible information and emotional support around the time of ileostomy closure, and found that eLARS addressed these challenges.
eLARS is a feasible educational and supportive care intervention for patients with LARS and has the potential to improve patients' quality of life.
直肠前切除术常伴有明显的肠道功能障碍，即低位前切除综合征（LARS），这对患者的生活质量有负面影响。我们为直肠癌幸存者开发了一个关于 LARS 的在线以患者为中心的应用程序（eLARS）。本研究的主要目的是评估 eLARS 在直肠前切除术后患有 LARS 的直肠癌幸存者中的可行性。次要目的是探讨参与者对 LARS 和 eLARS 应用程序的体验。
这是一项混合方法研究，包括可行性和定性分析。参与者为在 3 年内接受直肠前切除术治疗直肠癌、完成所有辅助治疗且术后出现肠道功能障碍的直肠癌幸存者。在 2 个月的研究期间，参与者可以使用该应用程序。可行性定义为 75%的研究参与者每月至少使用该应用程序 4 次。研究结束后对参与者进行半结构式访谈，并采用主题分析进行分析。
我们的样本包括 8 名直肠癌幸存者，5 名女性和 3 名男性。中位年龄为 58.5 岁（56.5-64.5）。大多数参与者（75%）在直肠前切除术后>1 年。75%的研究参与者在 2 个月内每月至少使用该应用程序 4 次。我们的主题分析表明，参与者感到在造口关闭时缺乏可信信息和情感支持，而 eLARS 解决了这些挑战。
eLARS 是一种针对 LARS 患者的可行的教育和支持性护理干预措施，有可能提高患者的生活质量。
