The Diagnosis and Evolution of Patients with LARS Syndrome: A Five-Year Retrospective Study from a Single Surgery Unit.

Simple Summary: Low anterior resection syndrome (LARS) encompasses a multitude of gastrointestinal symptoms that arise secondary to low and very-low anterior rectal resection performed for rectal cancer. This syndrome can affect a significant percentage of patients and impacts life for varying periods or may become permanent, requiring conversion to a permanent colostomy. For this reason, LARS has begun to be studied and recognized by surgeons and oncologists, and patients must be informed about the possibility of developing this condition after curative surgery. The study was conducted on 102 patients diagnosed and operated on for upper, middle, and lower rectal neoplasm, where resection was accompanied by partial or total mesorectal excision, and who exhibited at least one symptom associated with LARS. Obesity, the size of the remaining rectum, total mesorectal excision, anastomotic complications, and prolonged ileostomy time are convergent factors in the etiology of LARS. Objectives: The aim of the study was to assess the diagnosis and evolution of low anterior rectal resection syndrome (LARS) in patients admitted to a tertiary surgical center in Romania. Materials and Methods: From 120 patients initially included in the analysis, after applying the exclusion criteria, we selected 102 patients diagnosed and operated on for neoplasm of the upper, middle, and lower rectum for which resection and excision (partial or total) of mesorectum was associated. All the patients we treated in the general surgery department of the County Emergency Hospital of Craiova within a time frame of 5 years (1 October 2017–1 September 2022), and all experienced at least one symptom associated with LARS. The group included 68 men and 34 women aged between 35 and 88, who were followed-up for at least 2 years. Patients with progression of neoplastic disease, with advanced neurological disease, and those who died less than 2 years after surgery were excluded. Results: The overall incidence varied by gender, site of the tumor (requiring a certain type of surgery), and anastomotic complications, and it was directly proportional to the time interval between resection and restoration of continuity of digestion. Conclusions: Obesity, size of the remaining rectum, total excision of the mesorectum, anastomotic complications, and prolonged ileostomy time are cofactors in the etiology of LARS. The LARS score decreased in most patients during the 2-year follow-up, although there were a small number of patients in whom the decrease was insignificant. The persistence of major LARS at 6 months after surgery may predict the need for a definitive colostomy. [ABSTRACT FROM AUTHOR]