Low anterior rectal resection; the impact of anastomotic fistula on incidence and severity of low anterior resection syndrome

Authors

Georgiana Cotofana-Graure, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Cecil Mirea, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Silviu Daniel Preda, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Stefan Patrascu, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Tiberiu Stefanita Tenea-Cojan, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Adina Turcu-Stiolica, University of Medicine and Pharmacy of Craiova, Department of Pharmacoeconomics and Statistical Analysis in Clinical Trials and Pharmaceutical Research, Craiova, RomaniaFollow
Alexandru Munteanu, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Vlad Padureanu, University of Medicine and Pharmacy of Craiova, Department of Internal Medicine, Craiova, RomaniaFollow
Dragos Margaritescu, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Sandu Ramboiu, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Dan Cartu, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Valeriu Surlin, University of Medicine and Pharmacy of Craiova, Department of Surgery, Craiova, RomaniaFollow
Petru Radu, Carol Davila University of Medicine and Pharmacy, Department of Surgery, Bucharest, RomaniaFollow

Abstract

Objectives. Low anterior resection is a common surgical procedure for rectal cancer, but it is associated with a distressing complication known as Low Anterior Resection Syndrome (LARS). The incidence of LARS varies, with severe symptoms persisting in some patients even years after surgery. This study aimed to investigate the association between anastomotic leak and LARS severity in rectal cancer patients. Methods. A retrospective analysis was conducted on 100 rectal cancer patients who underwent LAR between 2017 and 2021. Patients were categorized based on LARS questionnaire responses into groups with anastomotic leakage and LARS, LARS alone, or no LARS. Various factors, including demographics, comorbidities, tumor characteristics, and surgical details, were analyzed for their association with LARS. Results. In our study, anastomotic leakage was observed in 23 patients, and 17 of them subsequently developed LARS. Male gender, age over 70, and neoadjuvant therapy were identified as risk factors for LARS. Additionally, LARS was more prevalent in patients with medium and low rectal cancers and those with a protective ostomy. Conclusion. Our findings suggest that male sex and neoadjuvant chemoradiotherapy are associated with the development of LARS in rectal cancer patients undergoing low anterior resection. The timing of stoma closure and the extent of neorectal reservoir may also impact LARS severity.

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Recommended Citation

Cotofana-Graure, Georgiana; Mirea, Cecil; Preda, Silviu Daniel; Patrascu, Stefan; Tenea-Cojan, Tiberiu Stefanita; Turcu-Stiolica, Adina; Munteanu, Alexandru; Padureanu, Vlad; Margaritescu, Dragos; Ramboiu, Sandu; Cartu, Dan; Surlin, Valeriu; and Radu, Petru (2024) "Low anterior rectal resection; the impact of anastomotic fistula on incidence and severity of low anterior resection syndrome," Journal of Mind and Medical Sciences: Vol. 11: Iss. 1, Article 18.
DOI: https://doi.org/10.22543/2392-7674.1465
Available at: https://scholar.valpo.edu/jmms/vol11/iss1/18