Predictive factors of major low anterior resection syndrome after surgery for rectal tumors

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Published Oct 8, 2024
https://doi.org/10.62438/tunismed.v102i10.5177
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Vol. 102 No. 10 (2024): Tunis Med oct 2024

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Mohamed Mehdi Trabelsi
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Imen Samaali
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Neirouz Kammoun
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Amine Ben Safta
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Annouar Oueslati
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Wejih Dougaz
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Mehdi Khalfallah
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Hichem Jerraya
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Ibtissem Bouasker
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Ramzi Nouira
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia
Chadli Dziri
Department B of Surgery, Charles Nicolle Hospital, University Tunis El Manar, Tunis, Tunisia

Abstract

Aim : To describe the epidemiological and clinical data of impaired functional outcome secondary to anterior resection of the rectum and to identify the predictive factors of major low anterior resection syndrome (LARS)


Methods : This retrospective study considered patients operated on for rectal tumors in surgical department in our hospital, between January 1st,2009 and December 31st, 2021. The primary outcome measure was the development of a major LARS immediately or after stoma closure. In order to identify independent predictors of major LARS, patients were divided into two groups: the "Major LARS" group and the "No Major LARS" group, and then we carried out a descriptive study, followed by an analytical study with logistic regression.


Results: We enrolled 42 patients operated for rectal tumor and had an anterior resection. Half of our patients developed LARS of which 14 developed major LARS. The median time to onset of LARS symptoms was 9 [2 -24] months.


At the end of this study, 2 factors were retained: age (OR=2.48; CI95% [1.2- 5.10], p=0.012) and pT3T4 stage (OR=5.95; CI95% [1.07- 33.33], p=0.041) as independent predictive factors of a major LARS. Neoadjuvant therapy was also a risk factor for major LARS in our study with a statistically significant difference (p=0.025) between the two groups "Major LARS" and "No major LARS".


Conclusion: LARS should be appropriately considered in the management of rectal cancer. Based on our results and data from the literature, age and mesorectal invasion were found to be independent predictors of major LARS.

Keywords:

Anterior rectal resection, Rectal tumor, Risk factors, Functional sequelae, Bowel function

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