Incidence and influencing factors of major low anterior resection syndrome within six months after sphincter-preserving surgery for rectal cancer patients
10.19405/j.cnki.issn1000–1492.2026.05 016
- VernacularTitle:直肠癌保肛患者术后半年内重度低位前切除综合征发生现状及影响因素分析
- Author:
Minjing SHEN
1
;
Chunxia REN
1
;
Lin SUN
2
;
Lei LIU
3
;
Yaodong ZHU
3
;
Qiang ZHOU
2
Author Information
1. School of Nursing， Anhui Medical University， Hefei 230032
2. Department of General Surgery，The First Affiliated Hospital of USTC，Division of Life Sciences and Medicine， University of Science and Technology of China， Hefei 230001
3. Department of General Surgery， The First Affiliated Hospital of Anhui Medical University， Hefei 230022
- Publication Type:Journal Article
- Keywords:
rectal cancer;
sphincter-preserving surgery;
postoperative;
major low anterior resection syndrome;
current status of occurrence;
influencing factors
- From:
Acta Universitatis Medicinalis Anhui
2026;61(5):914-922
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the incidence of major low anterior resection syndrome （LARS） within six months after sphincter-preserving surgery for rectal cancer and to analyze its associated factors. MethodsClinical records， postoperative rehabilitation data and LARS scores were collected from 889 patients at 3 months postoperatively and from 844 patients at 6 months postoperatively. Patients were divided into a major LARS group and a non-major LARS group. Multivariable Logistic regression was used to analyze factors associated with major LARS at 3 and 6 months postoperatively， and the predictive value of the models was assessed using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic （ROC）. ResultsAmong patients undergoing sphincter-preserving surgery for rectal cancer， 247 patients （27.8%） had major LARS at 3 months postoperatively and 181 patients （21.4%） at 6 months postoperatively. Multivariable Logistic regression showed that Kegel exercises， preoperative radiotherapy， anastomotic leakage， a tumor distance from the anal verge of ≤5 cm， and an anastomotic distance from the anal verge of ≤5 cm were independent factors for major LARS at 3 months postoperatively （P<0.05）. At 6 months postoperatively， occasional Kegel exercises during 0~3 months， Kegel exercises during 4~6 months， hydrotherapy during 4~6 months， preoperative chemotherapy， a tumor distance from the anal verge of ≤5 cm， and an anastomotic distance from the anal verge of ≤5 cm were independent factors （P<0.05）. The models at 3 and 6 months postoperatively showed goodness-of-fit test P values of 0.986 and 0.517 and area under the curve （AUCs） of 0.843 and 0.870， indicating good predictive value. ConclusionThe incidence of major LARS within six months after sphincter-preserving surgery for rectal cancer is relatively high， and greater attention should be paid to patients who receive preoperative chemoradiotherapy， develop anastomotic leakage， or have tumor and anastomotic distances from the anal verge of ≤5 cm. Patients should also be advised that early postoperative Kegel exercises and hydrotherapy may reduce the incidence of major LARS.
