Rehabilitation strategies for low anterior resection syndrome. A systematic review

Ann Ist Super Sanita. 2020 Jan-Mar;56(1):38-47. doi: 10.4415/ANN_20_01_07.

Abstract

Objective: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer.

Methods: We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria.

Results: The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment.

Conclusions: In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s.

Publication types

  • Systematic Review

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / surgery*
  • Antineoplastic Agents / therapeutic use
  • Colectomy / adverse effects*
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / radiotherapy
  • Colorectal Neoplasms / surgery*
  • Combined Modality Therapy
  • Defecation
  • Exercise Therapy
  • Fecal Incontinence / etiology
  • Fecal Incontinence / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Implantable Neurostimulators
  • Lumbosacral Plexus / physiopathology
  • Male
  • Middle Aged
  • Postoperative Complications / rehabilitation*
  • Prospective Studies
  • Quality of Life
  • Rectum / surgery*
  • Retrospective Studies
  • Syndrome
  • Tibial Nerve / physiopathology
  • Transcutaneous Electric Nerve Stimulation*
  • Urination Disorders / etiology
  • Urination Disorders / rehabilitation

Substances

  • Antineoplastic Agents