Effect of low anterior resection syndrome on quality of life in colorectal cancer patients: A retrospective observational study

Dong-Ai Jin; Fang-Ping Gu; Tao-Li Meng; Xuan-Xuan Zhang

doi:10.4240/wjgs.v15.i10.2123

Effect of low anterior resection syndrome on quality of life in colorectal cancer patients: A retrospective observational study

World J Gastrointest Surg. 2023 Oct 27;15(10):2123-2132. doi: 10.4240/wjgs.v15.i10.2123.

Authors

Dong-Ai Jin¹, Fang-Ping Gu¹, Tao-Li Meng¹, Xuan-Xuan Zhang²

Affiliations

¹ Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China.
² Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China. 8018041@zju.edu.cn.

Abstract

Background: Low anterior resection syndrome (LARS) is a common complication of anus-preserving surgery in patients with colorectal cancer, which significantly affects patients' quality of life.

Aim: To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.

Methods: We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires. According to the LARS score results, the patients were divided into no LARS, mild LARS, and severe LARS groups. The incidence of LARS and the effects of this condition on patient quality of life were determined. Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS. Based on these factors, we established a risk prediction model for LARS and evaluated its performance.

Results: Among the 223 patients included, 51 did not develop LARS and 171 had mild or severe LARS. The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS: Physical, role, emotional, and cognitive function, total health status, fatigue, pain, shortness of breath, insomnia, constipation, and diarrhea. Tumor size, partial/total mesorectal excision, colostomy, preoperative radiotherapy, and neoadjuvant chemotherapy were identified to be independent risk factors for LARS. A LARS prediction model was successfully established, which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.

Conclusion: The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.

Keywords: Colorectal cancer; Low anterior resection syndrome; Precision nursing; Prediction model; Quality of life; Risk factors.