Jin DA, Gu FP, Meng TL, Zhang XX. Effect of low anterior resection syndrome on quality of life in colorectal cancer patients: A retrospective observational study. World J Gastrointest Surg 2023; 15(10): 2123-2132 [PMID: 37969698 DOI: 10.4240/wjgs.v15.i10.2123]
Corresponding Author of This Article
Xuan-Xuan Zhang, MD, Chief Doctor, Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, No. 1 Shangcheng Road, Yiwu 322000, Zhejiang Province, China. 8018041@zju.edu.cn
Research Domain of This Article
Nursing
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dong-Ai Jin, Fang-Ping Gu, Tao-Li Meng, Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Xuan-Xuan Zhang, Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
Author contributions: Jin DA conceptualized and designed the study; Gu FP collected the data; Meng TL analyzed the data; Zhang XX wrote the original draft.
Supported bythe Zhejiang Provincial Education Department Project, No. Y202249777 and No. Y201941473.
Institutional review board statement: The study was reviewed and approved by the Sir Run Run Shaw Hospital Medical Ethics Committee (No. 20210607-31).
Informed consent statement: This study was a retrospective study, and the process of data collection, data analysis, and paper writing did not disclose patients' private information, so no informed consent was signed.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for the article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuan-Xuan Zhang, MD, Chief Doctor, Department of Ultrasound, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, No. 1 Shangcheng Road, Yiwu 322000, Zhejiang Province, China. 8018041@zju.edu.cn
Received: July 4, 2023 Peer-review started: July 4, 2023 First decision: July 19, 2023 Revised: August 1, 2023 Accepted: August 15, 2023 Article in press: August 15, 2023 Published online: October 27, 2023 Processing time: 115 Days and 0.1 Hours
Abstract
BACKGROUND
Low anterior resection syndrome (LARS) is a common complication of anus-preserving surgery in patients with colorectal cancer, which significantly affects patients' quality of life.
AIM
To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.
METHODS
We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires. According to the LARS score results, the patients were divided into no LARS, mild LARS, and severe LARS groups. The incidence of LARS and the effects of this condition on patient quality of life were determined. Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS. Based on these factors, we established a risk prediction model for LARS and evaluated its performance.
RESULTS
Among the 223 patients included, 51 did not develop LARS and 171 had mild or severe LARS. The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS: Physical, role, emotional, and cognitive function, total health status, fatigue, pain, shortness of breath, insomnia, constipation, and diarrhea. Tumor size, partial/total mesorectal excision, colostomy, preoperative radiotherapy, and neoadjuvant chemotherapy were identified to be independent risk factors for LARS. A LARS prediction model was successfully established, which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.
CONCLUSION
The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.
Core Tip: Low anterior resection syndrome (LARS) is a common complication of anus-preserving surgery in patients with colorectal cancer. In this study, we found that LARS significantly affected patients’ quality of life after colorectal cancer surgery, and that perioperative precision nursing could significantly reduce the incidence of LARS and improve patients’ quality of life. Furthermore, we established a LARS prediction model, which showed excellent performance in predicting the occurrence of LARS after colorectal cancer surgery. This prediction model can enable implementation of perioperative precision nursing to improve the quality of life of patients with LARS.
