Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study

Mira Mekhael; Helle O. Kristensen; Mette Borre; Asbjørn M. Drewes; Katrine J. Emmertsen; Janne Fassov; Klaus Krogh; Michael B. Lauritzen; Søren Laurberg; Jakob Lykke Poulsen; Ole Thorlacius-Ussing; Peter Christensen; Therese Juul

doi:10.1097/SLA.0000000000006714

Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study

Mira Mekhael^*, Helle O. Kristensen, Mette Borre, Asbjørn M. Drewes, Katrine J. Emmertsen, Janne Fassov, Klaus Krogh, Michael B. Lauritzen, Søren Laurberg, Jakob Lykke Poulsen, Ole Thorlacius-Ussing, Peter Christensen, Therese Juul

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Objective: To evaluate the outcomes of a multidisciplinary effort involving surgical and gastroenterological departments in managing bowel dysfunction, specifically low anterior resection syndrome (LARS), following rectal cancer treatment. Summary Background Data: An increasing number of rectal cancer survivors experience LARS, heightening the need for specialized treatment. Methods: Patients referred to our late sequelae clinics with LARS following sphincter-preserving treatment were eligible for inclusion. Patients were treated in the surgical or gastroenterological units or both based on symptoms. Patients completed patient-reported outcome measures at the first visit, upon discharge, and 12 months after discharge. Treatment outcomes were evaluated by the LARS score and its five single items, six single items covering additional LARS symptoms, the EuroQoL 5-dimension 5-level (EQ-5D-5L) VAS and utility scores, self-rated bowel function, and bowel function impact on quality of life (QoL). Results: We included 201 patients. Three-quarters were treated in the surgical units, whereas the rest required gastroenterological treatment. After treatment, the mean LARS score decreased by 4.7 points (P<0.001), whereas the mean EQ-VAS and utility score increased by 7.1 (P<0.001) and 0.06 points (P<0.001), respectively. All individual symptoms significantly improved. Improvement in self-rated bowel function and bowel function impact on QoL were 55.8% (P<0.001) and 45.7% (P<0.001), respectively. Similar results were recorded at the 12-month follow-up. Conclusion: These results encourage establishing late sequelae clinics with a joint gastroenterological and surgical approach to treat LARS following rectal cancer treatment.

Original language	English
Journal	Annals of Surgery
ISSN	0003-4932
DOIs	https://doi.org/10.1097/SLA.0000000000006714
Publication status	E-pub / Early view - 2025

Keywords

bowel dysfunction
Low Anterior Resection Syndrome
Quality of Life
Rectal Cancer

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Mekhael, M., Kristensen, H. O., Borre, M., Drewes, A. M., Emmertsen, K. J., Fassov, J., Krogh, K., Lauritzen, M. B., Laurberg, S., Poulsen, J. L., Thorlacius-Ussing, O., Christensen, P., & Juul, T. (2025). Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study. Annals of Surgery. Advance online publication. https://doi.org/10.1097/SLA.0000000000006714

@article{2c0e3e9a96434fe6a1aa7b64a29fac29,

title = "Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study",

abstract = "Objective: To evaluate the outcomes of a multidisciplinary effort involving surgical and gastroenterological departments in managing bowel dysfunction, specifically low anterior resection syndrome (LARS), following rectal cancer treatment. Summary Background Data: An increasing number of rectal cancer survivors experience LARS, heightening the need for specialized treatment. Methods: Patients referred to our late sequelae clinics with LARS following sphincter-preserving treatment were eligible for inclusion. Patients were treated in the surgical or gastroenterological units or both based on symptoms. Patients completed patient-reported outcome measures at the first visit, upon discharge, and 12 months after discharge. Treatment outcomes were evaluated by the LARS score and its five single items, six single items covering additional LARS symptoms, the EuroQoL 5-dimension 5-level (EQ-5D-5L) VAS and utility scores, self-rated bowel function, and bowel function impact on quality of life (QoL). Results: We included 201 patients. Three-quarters were treated in the surgical units, whereas the rest required gastroenterological treatment. After treatment, the mean LARS score decreased by 4.7 points (P<0.001), whereas the mean EQ-VAS and utility score increased by 7.1 (P<0.001) and 0.06 points (P<0.001), respectively. All individual symptoms significantly improved. Improvement in self-rated bowel function and bowel function impact on QoL were 55.8% (P<0.001) and 45.7% (P<0.001), respectively. Similar results were recorded at the 12-month follow-up. Conclusion: These results encourage establishing late sequelae clinics with a joint gastroenterological and surgical approach to treat LARS following rectal cancer treatment.",

keywords = "bowel dysfunction, Low Anterior Resection Syndrome, Quality of Life, Rectal Cancer",

author = "Mira Mekhael and Kristensen, {Helle O.} and Mette Borre and Drewes, {Asbj{\o}rn M.} and Emmertsen, {Katrine J.} and Janne Fassov and Klaus Krogh and Lauritzen, {Michael B.} and S{\o}ren Laurberg and Poulsen, {Jakob Lykke} and Ole Thorlacius-Ussing and Peter Christensen and Therese Juul",

year = "2025",

doi = "10.1097/SLA.0000000000006714",

language = "English",

journal = "Annals of Surgery",

issn = "0003-4932",

publisher = "Wolters Kluwer Health",

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Mekhael, M, Kristensen, HO, Borre, M, Drewes, AM, Emmertsen, KJ , Fassov, J , Krogh, K, Lauritzen, MB, Laurberg, S, Poulsen, JL, Thorlacius-Ussing, O, Christensen, P & Juul, T 2025, 'Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study', Annals of Surgery. https://doi.org/10.1097/SLA.0000000000006714

TY - JOUR

T1 - Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics

T2 - A Prospective Cohort Study

AU - Mekhael, Mira

AU - Kristensen, Helle O.

AU - Borre, Mette

AU - Drewes, Asbjørn M.

AU - Emmertsen, Katrine J.

AU - Fassov, Janne

AU - Krogh, Klaus

AU - Lauritzen, Michael B.

AU - Laurberg, Søren

AU - Poulsen, Jakob Lykke

AU - Thorlacius-Ussing, Ole

AU - Christensen, Peter

AU - Juul, Therese

PY - 2025

Y1 - 2025

N2 - Objective: To evaluate the outcomes of a multidisciplinary effort involving surgical and gastroenterological departments in managing bowel dysfunction, specifically low anterior resection syndrome (LARS), following rectal cancer treatment. Summary Background Data: An increasing number of rectal cancer survivors experience LARS, heightening the need for specialized treatment. Methods: Patients referred to our late sequelae clinics with LARS following sphincter-preserving treatment were eligible for inclusion. Patients were treated in the surgical or gastroenterological units or both based on symptoms. Patients completed patient-reported outcome measures at the first visit, upon discharge, and 12 months after discharge. Treatment outcomes were evaluated by the LARS score and its five single items, six single items covering additional LARS symptoms, the EuroQoL 5-dimension 5-level (EQ-5D-5L) VAS and utility scores, self-rated bowel function, and bowel function impact on quality of life (QoL). Results: We included 201 patients. Three-quarters were treated in the surgical units, whereas the rest required gastroenterological treatment. After treatment, the mean LARS score decreased by 4.7 points (P<0.001), whereas the mean EQ-VAS and utility score increased by 7.1 (P<0.001) and 0.06 points (P<0.001), respectively. All individual symptoms significantly improved. Improvement in self-rated bowel function and bowel function impact on QoL were 55.8% (P<0.001) and 45.7% (P<0.001), respectively. Similar results were recorded at the 12-month follow-up. Conclusion: These results encourage establishing late sequelae clinics with a joint gastroenterological and surgical approach to treat LARS following rectal cancer treatment.

AB - Objective: To evaluate the outcomes of a multidisciplinary effort involving surgical and gastroenterological departments in managing bowel dysfunction, specifically low anterior resection syndrome (LARS), following rectal cancer treatment. Summary Background Data: An increasing number of rectal cancer survivors experience LARS, heightening the need for specialized treatment. Methods: Patients referred to our late sequelae clinics with LARS following sphincter-preserving treatment were eligible for inclusion. Patients were treated in the surgical or gastroenterological units or both based on symptoms. Patients completed patient-reported outcome measures at the first visit, upon discharge, and 12 months after discharge. Treatment outcomes were evaluated by the LARS score and its five single items, six single items covering additional LARS symptoms, the EuroQoL 5-dimension 5-level (EQ-5D-5L) VAS and utility scores, self-rated bowel function, and bowel function impact on quality of life (QoL). Results: We included 201 patients. Three-quarters were treated in the surgical units, whereas the rest required gastroenterological treatment. After treatment, the mean LARS score decreased by 4.7 points (P<0.001), whereas the mean EQ-VAS and utility score increased by 7.1 (P<0.001) and 0.06 points (P<0.001), respectively. All individual symptoms significantly improved. Improvement in self-rated bowel function and bowel function impact on QoL were 55.8% (P<0.001) and 45.7% (P<0.001), respectively. Similar results were recorded at the 12-month follow-up. Conclusion: These results encourage establishing late sequelae clinics with a joint gastroenterological and surgical approach to treat LARS following rectal cancer treatment.

KW - bowel dysfunction

KW - Low Anterior Resection Syndrome

KW - Quality of Life

KW - Rectal Cancer

UR - http://www.scopus.com/inward/record.url?scp=105002691032&partnerID=8YFLogxK

U2 - 10.1097/SLA.0000000000006714

DO - 10.1097/SLA.0000000000006714

M3 - Journal article

C2 - 40168548

AN - SCOPUS:105002691032

SN - 0003-4932

JO - Annals of Surgery

JF - Annals of Surgery

ER -

Treatment of Low Anterior Resection Syndrome in Specialized Multidisciplinary Late Sequelae Clinics: A Prospective Cohort Study

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Keywords

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