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Low anterior resection syndrome

MedGen UID:
1697708
•Concept ID:
C4524073
•
Disease or Syndrome
Synonym: Low Anterior Resection Syndrome
SNOMED CT: Low anterior resection syndrome (870625007); LARS - low anterior resection syndrome (870625007)

Definition

A collection of symptoms following removal of part or all of the rectum that may include frequency or urgency of stools, numerous bowel movements over a few hours, fecal incontinence, constipation alternating with numerous bowel movements, and/or increased intestinal gas. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLow anterior resection syndrome

Professional guidelines

PubMed

Low Anterior Resection Syndrome: Predisposing Factors and Treatment.
Garfinkle R, Boutros M
Surg Oncol 2022 Aug;43:101691. Epub 2021 Nov 25 doi: 10.1016/j.suronc.2021.101691. PMID: 34863592
Management guidelines for low anterior resection syndrome - the MANUEL project.
Christensen P, Im Baeten C, Espín-Basany E, Martellucci J, Nugent KP, Zerbib F, Pellino G, Rosen H; MANUEL Project Working Group
Colorectal Dis 2021 Feb;23(2):461-475. Epub 2021 Jan 24 doi: 10.1111/codi.15517. PMID: 33411977Free PMC Article
Neoadjuvant radiotherapy for rectal cancer management.
Feeney G, Sehgal R, Sheehan M, Hogan A, Regan M, Joyce M, Kerin M
World J Gastroenterol 2019 Sep 7;25(33):4850-4869. doi: 10.3748/wjg.v25.i33.4850. PMID: 31543678Free PMC Article

Recent clinical studies

Therapy

Ondansetron for Low Anterior Resection Syndrome (LARS): A Double-Blind, Placebo-Controlled, Cross-Over, Randomized Study.
Popeskou SG, Roesel R, Faes S, Vanoni A, Galafassi J, di Tor Vajana AF, Piotet LM, Christoforidis D
Ann Surg 2024 Feb 1;279(2):196-202. Epub 2023 Jul 13 doi: 10.1097/SLA.0000000000005995. PMID: 37436844
Preventative strategies for low anterior resection syndrome.
Brock H, Lambrineas L, Ong HI, Chen WY, Das A, Edsell A, Proud D, Carrington E, Smart P, Mohan H, Burgess A
Tech Coloproctol 2023 Dec 13;28(1):10. doi: 10.1007/s10151-023-02872-5. PMID: 38091118
The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome: A Multicenter Randomized Controlled Trial.
Asnong A, D'Hoore A, Van Kampen M, Wolthuis A, Van Molhem Y, Van Geluwe B, Devoogdt N, De Groef A, Guler Caamano Fajardo I, Geraerts I
Ann Surg 2022 Nov 1;276(5):761-768. Epub 2022 Jul 27 doi: 10.1097/SLA.0000000000005632. PMID: 35894434Free PMC Article
Low Anterior Resection Syndrome.
Nguyen TH, Chokshi RV
Curr Gastroenterol Rep 2020 Aug 4;22(10):48. doi: 10.1007/s11894-020-00785-z. PMID: 32749603Free PMC Article
Neoadjuvant radiotherapy for rectal cancer management.
Feeney G, Sehgal R, Sheehan M, Hogan A, Regan M, Joyce M, Kerin M
World J Gastroenterol 2019 Sep 7;25(33):4850-4869. doi: 10.3748/wjg.v25.i33.4850. PMID: 31543678Free PMC Article

Prognosis

Development and Validation of a Post-Radiotherapy Prediction Model for Bowel Dysfunction After Rectal Cancer Resection.
Qin Q, Huang B, Wu A, Gao J, Liu X, Cao W, Ma T, Kuang Y, Guo J, Wu Q, Shao B, Guan Q, Yao H, Zhang X, Wang H; Chinese Radiation Intestinal Injury Research Group
Gastroenterology 2023 Dec;165(6):1430-1442.e14. Epub 2023 Aug 23 doi: 10.1053/j.gastro.2023.08.022. PMID: 37625498
Low anterior resection syndrome (LARS) after sphincter-sparing rectal cancer surgery. Incidence and risk factors.
Yazici H, Dalkilic MS, Akin MI, Yegen SC, Attaallah W
Ann Ital Chir 2022;93:566-570. PMID: 36398766
MRI measurements predict major low anterior resection syndrome in rectal cancer patients.
Zhang XY, Liu XZ, Li XT, Wang L, Zhu HB, Sun RJ, Guan Z, Lu QY, Zhu HT, Wang WH, Li ZW, Wu AW, Sun YS
Int J Colorectal Dis 2022 Jun;37(6):1239-1249. Epub 2022 May 3 doi: 10.1007/s00384-022-04169-9. PMID: 35503128
The Longitudinal Course of Low-anterior Resection Syndrome: An individual Patient Meta-analysis.
Varghese C, Wells CI, O'Grady G, Christensen P, Bissett IP, Keane C; on behalf of the Longitudinal LARS Group
Ann Surg 2022 Jul 1;276(1):46-54. Epub 2022 Feb 17 doi: 10.1097/SLA.0000000000005423. PMID: 35185131
Transanal total mesorectal excision and low anterior resection syndrome.
van der Heijden JAG, Qaderi SM, Verhoeven R, Custers JAE, Klarenbeek BR, Maaskant-Braat AJG, de Wilt JHW; PLCRC group
Br J Surg 2021 Aug 19;108(8):991-997. doi: 10.1093/bjs/znab056. PMID: 33837383

Clinical prediction guides

Ondansetron for Low Anterior Resection Syndrome (LARS): A Double-Blind, Placebo-Controlled, Cross-Over, Randomized Study.
Popeskou SG, Roesel R, Faes S, Vanoni A, Galafassi J, di Tor Vajana AF, Piotet LM, Christoforidis D
Ann Surg 2024 Feb 1;279(2):196-202. Epub 2023 Jul 13 doi: 10.1097/SLA.0000000000005995. PMID: 37436844
Development and Validation of a Post-Radiotherapy Prediction Model for Bowel Dysfunction After Rectal Cancer Resection.
Qin Q, Huang B, Wu A, Gao J, Liu X, Cao W, Ma T, Kuang Y, Guo J, Wu Q, Shao B, Guan Q, Yao H, Zhang X, Wang H; Chinese Radiation Intestinal Injury Research Group
Gastroenterology 2023 Dec;165(6):1430-1442.e14. Epub 2023 Aug 23 doi: 10.1053/j.gastro.2023.08.022. PMID: 37625498
The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome: A Multicenter Randomized Controlled Trial.
Asnong A, D'Hoore A, Van Kampen M, Wolthuis A, Van Molhem Y, Van Geluwe B, Devoogdt N, De Groef A, Guler Caamano Fajardo I, Geraerts I
Ann Surg 2022 Nov 1;276(5):761-768. Epub 2022 Jul 27 doi: 10.1097/SLA.0000000000005632. PMID: 35894434Free PMC Article
Low Anterior Resection Syndrome.
Nguyen TH, Chokshi RV
Curr Gastroenterol Rep 2020 Aug 4;22(10):48. doi: 10.1007/s11894-020-00785-z. PMID: 32749603Free PMC Article
Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer.
Emmertsen KJ, Laurberg S
Ann Surg 2012 May;255(5):922-8. doi: 10.1097/SLA.0b013e31824f1c21. PMID: 22504191

Recent systematic reviews

Treatment of anterior resection syndrome: A systematic review and network meta-analysis.
Zhou L, Zhang Z, Wang L
Eur J Surg Oncol 2024 Jun;50(6):108336. Epub 2024 Apr 10 doi: 10.1016/j.ejso.2024.108336. PMID: 38626589
Preventative strategies for low anterior resection syndrome.
Brock H, Lambrineas L, Ong HI, Chen WY, Das A, Edsell A, Proud D, Carrington E, Smart P, Mohan H, Burgess A
Tech Coloproctol 2023 Dec 13;28(1):10. doi: 10.1007/s10151-023-02872-5. PMID: 38091118
Sacral neuromodulation for low anterior resection syndrome: current status-a systematic review and meta-analysis.
Pires M, Severo M, Lopes A, Neves S, Matzel K, Povo A
Int J Colorectal Dis 2023 Jul 10;38(1):189. doi: 10.1007/s00384-023-04485-8. PMID: 37428256
Systematic review and meta-analysis of randomized clinical trials on the treatment of low anterior resection syndrome.
Emile SH, Garoufalia Z, Barsom S, Horesh N, Gefen R, Zhou P, Wexner SD
Surgery 2023 Jun;173(6):1352-1358. Epub 2023 Apr 1 doi: 10.1016/j.surg.2023.02.010. PMID: 37012144
Defining low anterior resection syndrome: a systematic review of the literature.
Keane C, Wells C, O'Grady G, Bissett IP
Colorectal Dis 2017 Aug;19(8):713-722. doi: 10.1111/codi.13767. PMID: 28612460

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