Low anterior resection syndrome: Future directions in treatment and prevention

There has been a recent increase in patient reported outcomes, specifically quality of life (QoL), following recovery from a restorative proctectomy. The constellation of post-operative bowel dysfunction symptoms has been collectively termed the Low Anterior Resection Syndrome (LARS). Research efforts have resulted in an international consensus statement on its definition and now establishes a foundation of future research on LARS incidence, significance and treatment options. Amidst the myriad of prior treatment options, all efforts by surgeons to provide organ (anus) preservation surgery have unfortunately resulted in an increasing number of patients who intensely suffer from LARS. Perhaps historically considered only for failure of symptom management by both surgeons and patients alike, use of a permanent colostomy may be an appropriate surgical outcome outright when patients are fully informed of what post-operative bowel “dysfunction” is likely to be expected. Still, the future of LARS treatments is just beginning to be investigated and increased physician awareness of those new management strategies may offer hope for patients who continually struggle with their QoL following a restorative proctectomy.