Low Anterior Resection Syndrome in a Reference North American Sample: Prevalence and Associated Factors.


Journal

Journal of the American College of Surgeons
ISSN: 1879-1190
Titre abrégé: J Am Coll Surg
Pays: United States
ID NLM: 9431305

Informations de publication

Date de publication:
01 11 2023
Historique:
medline: 23 10 2023
pubmed: 19 7 2023
entrez: 19 7 2023
Statut: ppublish

Résumé

Low anterior resection syndrome (LARS) is a well-described consequence of rectal cancer treatment. Studying the degree to which bowel dysfunction exists in the general population may help to better interpret to what extent LARS is related to disease and/or cancer treatment. Currently, North American LARS normative data are lacking. The aim of this study was to describe the prevalence of bowel dysfunction, as measured by the LARS score, and quality of life (QoL) in a reference North American sample. Quality of life was measured and associations between participant characteristics and LARS were identified. This was a single-institution cross-sectional study of asymptomatic adults who underwent screening and surveillance colonoscopies from 2018 to 2021 with no/benign endoscopic findings. Survey was conducted on select comorbidities, sociodemographic factors, LARS, and QoL. Outcomes were LARS and QoL. Multivariable linear regression accounting for a priori clinical factors associated with bowel dysfunction was performed. Of 1,004 subjects approached, 502 (50.0%) participated, and 135 (26.9%) participants had major/minor LARS. On multiple linear regression, female sex (β = 2.15, 95% CI 0.30 to 4.00), younger age (β = -0.10, 95% CI -0.18 to -0.03), White ethnicity (β = 2.45, 95% CI 0.15 to 4.74), and the presence of at least one of the following factors: diabetes, depression, neurologic disorder, or cholecystectomy (β = 3.54, 95% CI 1.57 to 5.51) were independently associated with a higher LARS score. Individuals with LARS had lower global QoL, functional subscales, and various symptom subscale scores. Our study identified the baseline prevalence of LARS in asymptomatic adults who have not undergone a low anterior resection. These normative data will allow for more accurate interpretation of ongoing studies on LARS in North American rectal cancer patients.

Sections du résumé

BACKGROUND
Low anterior resection syndrome (LARS) is a well-described consequence of rectal cancer treatment. Studying the degree to which bowel dysfunction exists in the general population may help to better interpret to what extent LARS is related to disease and/or cancer treatment. Currently, North American LARS normative data are lacking. The aim of this study was to describe the prevalence of bowel dysfunction, as measured by the LARS score, and quality of life (QoL) in a reference North American sample. Quality of life was measured and associations between participant characteristics and LARS were identified.
STUDY DESIGN
This was a single-institution cross-sectional study of asymptomatic adults who underwent screening and surveillance colonoscopies from 2018 to 2021 with no/benign endoscopic findings. Survey was conducted on select comorbidities, sociodemographic factors, LARS, and QoL. Outcomes were LARS and QoL. Multivariable linear regression accounting for a priori clinical factors associated with bowel dysfunction was performed.
RESULTS
Of 1,004 subjects approached, 502 (50.0%) participated, and 135 (26.9%) participants had major/minor LARS. On multiple linear regression, female sex (β = 2.15, 95% CI 0.30 to 4.00), younger age (β = -0.10, 95% CI -0.18 to -0.03), White ethnicity (β = 2.45, 95% CI 0.15 to 4.74), and the presence of at least one of the following factors: diabetes, depression, neurologic disorder, or cholecystectomy (β = 3.54, 95% CI 1.57 to 5.51) were independently associated with a higher LARS score. Individuals with LARS had lower global QoL, functional subscales, and various symptom subscale scores.
CONCLUSIONS
Our study identified the baseline prevalence of LARS in asymptomatic adults who have not undergone a low anterior resection. These normative data will allow for more accurate interpretation of ongoing studies on LARS in North American rectal cancer patients.

Identifiants

pubmed: 37466264
doi: 10.1097/XCS.0000000000000807
pii: 00019464-202311000-00001
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

679-688

Informations de copyright

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Auteurs

Jeongyoon Moon (J)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Alexa Ehlebracht (A)

Faculty of Medicine, McGill University, Montreal, QC, Canada (Ehlebracht, Cwintal).

Michelle Cwintal (M)

Faculty of Medicine, McGill University, Montreal, QC, Canada (Ehlebracht, Cwintal).

Julio Faria (J)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Gabriela Ghitulescu (G)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Nancy Morin (N)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Allison Pang (A)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Carol-Ann Vasilevsky (CA)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

Marylise Boutros (M)

From the Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada (Moon, Faria, Ghitulescu, Morin, Pang, Vasilevsky, Boutros).

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