The effect of the severity of low anterior resection syndrome on the quality of life in patients with rectal cancer: a meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yilin ¹ ,  HUANG Mingjun ² , XIONG Fangli ¹ , YU He ³ , WANG Xiaodong ⁴

1. West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
2. Day Service Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. West China School of Clinical Medicine, Sichuan University, Chengdu 610041, P. R. China;
4. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

HUANG Mingjun, Email: hmj123123@126.com

Keywords：

rectal cancer; low anterior resection syndrome; quality of life; meta-analysis

DOI：

10.7507/1007-9424.202105077

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the impact of the severity of low anterior resection syndrome (LARS) on the quality of life in patients with rectal cancer. Methods Literatures published from January 2012 to August 2020 in the Cochrane Library, PubMed, Embase, CNKI, WanFang and other databases were searched according to the search terms. Study screened, data extracted, and quality evaluated were conducted by three reviewers independently, and the RevMan 5.4 software was used for meta-analysis. Results Seven studies, involving 1 616 patients were included. Meta-analysis results showed that the functional scores (including overall health status, physiological functioning, role functioning, emotional functioning, cognitive functioning, and social functioning) of patients with major LARS were lower than those of patients with no/minor LARS (P<0.001). Except for appetite loss, the symptom score (including fatigue, nausea and vomiting, pain), shortness of breath, insomnia, constipation, diarrhea, and financial difficulties of patients with major LARS were higher than those of patients with no/minor LARS (P<0.01). Conclusion Major LARS has a greater impact on the quality of life of patients after surgery than no/minor LARS.

Citation： WANG Yilin, HUANG Mingjun, XIONG Fangli, YU He, WANG Xiaodong. The effect of the severity of low anterior resection syndrome on the quality of life in patients with rectal cancer: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(2): 179-187. doi: 10.7507/1007-9424.202105077 Copy

1.	郑民华, 马君俊. 微创技术在结直肠肿瘤手术功能保护的优势与弊端. 中华胃肠外科杂志, 2017, 20(6): 601-605.
2.	Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
3.	蒲羽, 邱远, 李祥, 等. 直肠癌保肛术后低位前切除综合征发生率、恢复情况及影响因素的回顾性分析. 第三军医大学学报, 2017, 39(10): 1025-1030.
4.	Ekkarat P, Boonpipattanapong T, Tantiphlachiva K, et al. Factors determining low anterior resection syndrome after rectal cancer resection: a study in Thai patients. Asian J Surg, 2016, 39(4): 225-231.
5.	中华人民共和国国家卫生健康委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2020年版). 中国实用外科杂志, 2020, 40(6): 601-625.
6.	Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg, 2012, 255(5): 922-928.
7.	Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
8.	Gujral S, Conroy T, Fleissner C, et al. Assessing quality of life in patients with colorectal cancer: an update of the EORTC quality of life questionnaire. Eur J Cancer, 2007, 43(10): 1564-1573.
9.	Wells GA, Shea B, Connell D, et al. The Newcastle-ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
10.	Carpelan A, Elamo E, Karvonen J, et al. Validation of the low anterior resection syndrome score in finnish patients: preliminary results on quality of life in different LARS severity groups. Scand J Surg, 2021, 110(3): 414-419.
11.	Chen TY, Wiltink LM, Nout RA, et al. Bowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial. Clin Colorectal Cancer, 2015, 14(2): 106-114.
12.	Emmertsen KJ, Laurberg S. Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer. Br J Surg, 2013, 100(10): 1377-1387.
13.	Kupsch J, Kuhn M, Matzel KE, et al. To what extent is the low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires? Int J Colorectal Dis, 2019, 34(4): 747-762.
14.	Pieniowski EHA, Nordenvall C, Palmer G, et al. Prevalence of low anterior resection syndrome and impact on quality of life after rectal cancer surgery: population-based study. BJS Open, 2020, 4(5): 935-942.
15.	Ribas Y, Aguilar F, Jovell-Fernández E, et al. Clinical application of the LARS score: results from a pilot study. Int J Colorectal Dis, 2017, 32(3): 409-418.
16.	徐玲, 丁曙晴, 丁义江. 直肠癌前切除术后生活质量及前切除综合征相关因素分析. 临床外科杂志, 2019, 27(12): 1049-1052.
17.	顾晋, 潘宏达. 直肠前切除综合征的防范与处理. 中华胃肠外科杂志, 2016, 19(4): 366-369.
18.	Kornmann VN, Walma MS, de Roos MA, et al. Quality of life after a low anterior resection for rectal cancer in elderly patients. Ann Coloproctol, 2016, 32(1): 27-32.
19.	Battersby NJ, Juul T, Christensen P, et al. Predicting the risk of bowel-related quality-of-life impairment after restorative resection for rectal cancer: a multicenter cross-sectional study. Dis Colon Rectum, 2016, 59(4): 270-280.
20.	Scheer AS, Boushey RP, Liang S, et al. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum, 2011, 54(12): 1589-1597.
21.	Pieniowski EHA, Palmer GJ, Juul T, et al. Low anterior resection syndrome and quality of life after sphincter-sparing rectal cancer surgery: a long-term longitudinal follow-up. Dis Colon Rectum, 2019, 62(1): 14-20.
22.	van Heinsbergen M, Janssen-Heijnen ML, Leijtens JW, et al. Bowel dysfunction after sigmoid resection underestimated: multicentre study on quality of life after surgery for carcinoma of the rectum and sigmoid. Eur J Surg Oncol, 2018, 44(8): 1261-1267.
23.	Pucciarelli S, Del Bianco P, Efficace F, et al. Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery. Support Care Cancer, 2010, 18(5): 601-608.
24.	Juul T, Ahlberg M, Biondo S, et al. Low anterior resection syndrome and quality of life: an international multicenter study. Dis Colon Rectum, 2014, 57(5): 585-591.
25.	谢玲女, 姚晓, 温春美, 等. 直肠癌LARS相关生活质量的质性研究. 2016浙江省肿瘤外科学术年会暨第二届钱江国际肿瘤外科高峰论坛论文汇编. 2016: 4.
26.	Bohlok A, Mercier C, Bouazza F, et al. The burden of low anterior resection syndrome on quality of life in patients with mid or low rectal cancer. Support Care Cancer, 2020, 28(3): 1199-1206.
27.	丁玉珍, 孙琳, 沈旻静, 等. Kegel运动联合水疗法对直肠癌患者术后发生低位直肠前切除综合征及生命质量的临床效果研究. 中国全科医学, 2018, 21(14): 1677-1681.
28.	吴晓丹, 符春凤, 陈依琳, 等. 生物反馈联合盆底肌锻炼对直肠癌低位保肛患者低位前切除综合征的作用. 中华医学杂志, 2019, 99(30): 2337-2343.
29.	许岩磊. 针灸促进直肠癌前切除术后排便功能恢复的研究. 南京: 南京中医药大学, 2013.
30.	许燕飞. 个体化生物反馈训练对直肠癌保肛术后肛门直肠动力学和肛门排便功能的影响. 中国实用护理杂志, 2020, 36(21): 1612-1617.
31.	雷亚楠, 丁健华, 卓光鑽, 等. 直肠癌前切除综合征的危险因素分析. 中国普外基础与临床杂志, 2016, 23(7): 809-812.
32.	蒋伟, 官海迪, 邱远, 等. 直肠癌术后低位前切除综合征的评估与治疗进展. 中国普外基础与临床杂志, 2020, 27(5): 624-628.

1. 郑民华, 马君俊. 微创技术在结直肠肿瘤手术功能保护的优势与弊端. 中华胃肠外科杂志, 2017, 20(6): 601-605.
2. Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
3. 蒲羽, 邱远, 李祥, 等. 直肠癌保肛术后低位前切除综合征发生率、恢复情况及影响因素的回顾性分析. 第三军医大学学报, 2017, 39(10): 1025-1030.
4. Ekkarat P, Boonpipattanapong T, Tantiphlachiva K, et al. Factors determining low anterior resection syndrome after rectal cancer resection: a study in Thai patients. Asian J Surg, 2016, 39(4): 225-231.
5. 中华人民共和国国家卫生健康委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2020年版). 中国实用外科杂志, 2020, 40(6): 601-625.
6. Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg, 2012, 255(5): 922-928.
7. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
8. Gujral S, Conroy T, Fleissner C, et al. Assessing quality of life in patients with colorectal cancer: an update of the EORTC quality of life questionnaire. Eur J Cancer, 2007, 43(10): 1564-1573.
9. Wells GA, Shea B, Connell D, et al. The Newcastle-ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
10. Carpelan A, Elamo E, Karvonen J, et al. Validation of the low anterior resection syndrome score in finnish patients: preliminary results on quality of life in different LARS severity groups. Scand J Surg, 2021, 110(3): 414-419.
11. Chen TY, Wiltink LM, Nout RA, et al. Bowel function 14 years after preoperative short-course radiotherapy and total mesorectal excision for rectal cancer: report of a multicenter randomized trial. Clin Colorectal Cancer, 2015, 14(2): 106-114.
12. Emmertsen KJ, Laurberg S. Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer. Br J Surg, 2013, 100(10): 1377-1387.
13. Kupsch J, Kuhn M, Matzel KE, et al. To what extent is the low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires? Int J Colorectal Dis, 2019, 34(4): 747-762.
14. Pieniowski EHA, Nordenvall C, Palmer G, et al. Prevalence of low anterior resection syndrome and impact on quality of life after rectal cancer surgery: population-based study. BJS Open, 2020, 4(5): 935-942.
15. Ribas Y, Aguilar F, Jovell-Fernández E, et al. Clinical application of the LARS score: results from a pilot study. Int J Colorectal Dis, 2017, 32(3): 409-418.
16. 徐玲, 丁曙晴, 丁义江. 直肠癌前切除术后生活质量及前切除综合征相关因素分析. 临床外科杂志, 2019, 27(12): 1049-1052.
17. 顾晋, 潘宏达. 直肠前切除综合征的防范与处理. 中华胃肠外科杂志, 2016, 19(4): 366-369.
18. Kornmann VN, Walma MS, de Roos MA, et al. Quality of life after a low anterior resection for rectal cancer in elderly patients. Ann Coloproctol, 2016, 32(1): 27-32.
19. Battersby NJ, Juul T, Christensen P, et al. Predicting the risk of bowel-related quality-of-life impairment after restorative resection for rectal cancer: a multicenter cross-sectional study. Dis Colon Rectum, 2016, 59(4): 270-280.
20. Scheer AS, Boushey RP, Liang S, et al. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum, 2011, 54(12): 1589-1597.
21. Pieniowski EHA, Palmer GJ, Juul T, et al. Low anterior resection syndrome and quality of life after sphincter-sparing rectal cancer surgery: a long-term longitudinal follow-up. Dis Colon Rectum, 2019, 62(1): 14-20.
22. van Heinsbergen M, Janssen-Heijnen ML, Leijtens JW, et al. Bowel dysfunction after sigmoid resection underestimated: multicentre study on quality of life after surgery for carcinoma of the rectum and sigmoid. Eur J Surg Oncol, 2018, 44(8): 1261-1267.
23. Pucciarelli S, Del Bianco P, Efficace F, et al. Health-related quality of life, faecal continence and bowel function in rectal cancer patients after chemoradiotherapy followed by radical surgery. Support Care Cancer, 2010, 18(5): 601-608.
24. Juul T, Ahlberg M, Biondo S, et al. Low anterior resection syndrome and quality of life: an international multicenter study. Dis Colon Rectum, 2014, 57(5): 585-591.
25. 谢玲女, 姚晓, 温春美, 等. 直肠癌LARS相关生活质量的质性研究. 2016浙江省肿瘤外科学术年会暨第二届钱江国际肿瘤外科高峰论坛论文汇编. 2016: 4.
26. Bohlok A, Mercier C, Bouazza F, et al. The burden of low anterior resection syndrome on quality of life in patients with mid or low rectal cancer. Support Care Cancer, 2020, 28(3): 1199-1206.
27. 丁玉珍, 孙琳, 沈旻静, 等. Kegel运动联合水疗法对直肠癌患者术后发生低位直肠前切除综合征及生命质量的临床效果研究. 中国全科医学, 2018, 21(14): 1677-1681.
28. 吴晓丹, 符春凤, 陈依琳, 等. 生物反馈联合盆底肌锻炼对直肠癌低位保肛患者低位前切除综合征的作用. 中华医学杂志, 2019, 99(30): 2337-2343.
29. 许岩磊. 针灸促进直肠癌前切除术后排便功能恢复的研究. 南京: 南京中医药大学, 2013.
30. 许燕飞. 个体化生物反馈训练对直肠癌保肛术后肛门直肠动力学和肛门排便功能的影响. 中国实用护理杂志, 2020, 36(21): 1612-1617.
31. 雷亚楠, 丁健华, 卓光鑽, 等. 直肠癌前切除综合征的危险因素分析. 中国普外基础与临床杂志, 2016, 23(7): 809-812.
32. 蒋伟, 官海迪, 邱远, 等. 直肠癌术后低位前切除综合征的评估与治疗进展. 中国普外基础与临床杂志, 2020, 27(5): 624-628.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The effect of the severity of low anterior resection syndrome on the quality of life in patients with rectal cancer: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content