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Annals of Gastroenterological Surgery
Article . 2023 . Peer-reviewed
License: CC BY
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PubMed Central
Other literature type . 2023
License: CC BY
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Low anterior resection syndrome

Authors: Seung‐Bum Ryoo;

Low anterior resection syndrome

Abstract

AbstractLow anterior resection syndrome (LARS) is the distressful defecatory functional problem after sphincter‐saving surgery for rectal cancer. Although the symptoms of fecal urgency, frequency, and incontinence may develop in most of the patients after surgery, there is no definitive treatments for LARS. Multifactorial etiologies and various risk factors have been identified, but the reduction of storage capacity in the rectum is one of the main reasons for LARS. Anal sphincter muscle or nerve damage during rectoanal resection or anastomosis construction, and intersphincteric resection for low‐lying tumors or hand‐sewing anastomosis, are the absolute risk factors for LARS. Preoperative radiotherapy, postoperative complications, such as anastomosis leakage, or longer duration of stoma, are also risk factors. The severity of LARS can be confirmed using the LARS score questionnaire. The questionnaire has been translated to numerous language versions including Korean and have been validated. Diverse empirical treatments, such as loperamide, fiber, probiotics, or enema, have been tried, but the safety and efficacy have not been verified yet. The 5‐Hydroxytryptamine (5‐HT) receptor antagonist, ramosetron, used for diarrhea‐dominant irritable bowel syndrome, is one potential drug for relieving the symptoms of major LARS. A randomized‐controlled trial suggested the use of ramosetron could be safe and efficacious for patients who have major LARS after sphincter‐saving rectal cancer surgery. Novel techniques or drugs for relieving the symptoms of LARS should be developed more and further studies are necessary.

Keywords

low anterior resection syndrome, quality of life, RD1-811, defecatory function, Surgery, RC799-869, Diseases of the digestive system. Gastroenterology, rectal cancer, compliance, Review Articles

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
16
Top 10%
Top 10%
Top 10%
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gold
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Cancer Research