Quality of Life and Bowel Dysfunction after Transanal Endoscopic Microsurgery for Rectal Cancer: One Third of Patients Experience Major Low Anterior Resection Syndrome

Maarten van Heinsbergen*, Jeroen W. Leijtens, Gerrit D. Slooter, Maryska L. Janssen-Heijnen, Joop L. Konsten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)
37 Downloads (Pure)

Abstract

Background/Aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. "Major LARS" was observed in 29% of patients and "minor LARS" in 26%. Female gender (OR 4.00; 95% CI 1.20-13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08-12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01-1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL. (C) 2019 S. Karger AG, Basel

Original languageEnglish
Pages (from-to)39-46
Number of pages8
JournalDigestive Surgery
Volume37
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • Colorectal cancer surgery
  • Transanal endoscopic microsurgery
  • Low anterior resection syndrome
  • Quality of life
  • NEOADJUVANT THERAPY
  • MESORECTAL EXCISION
  • RADIOTHERAPY
  • MULTICENTER
  • VALIDATION
  • OUTCOMES
  • IMPACT

Cite this