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Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026

Association of symptom complexes with consequence severity in low anterior resection syndrome after intersphincteric resection for ultralow rectal cancer: an exploratory cross-sectional study.

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Zhang Bin, Zou Chen-Chen, Ma Hai-Tao, Zhao Yu-Juan, Zhuo Guang-Zuan, Xiang Jian-Bin, Ding Jian-Hua

Аннотация

BACKGROUND: The international consensus delineates 8 symptom complexes and 8 consequences for defining low anterior resection syndrome (LARS). This exploratory cross-sectional study aimed to evaluate the differential associations between symptom complexes and consequence severity after intersphincteric resection (ISR) for ultralow rectal cancer.

METHODS: Patients were enrolled ≥12 months after diverting ileostomy reversal after ISR. The severity of the consensus-defined LARS variables was assessed using a 5-point Likert scale. Participants completed questionnaires on bowel function and condition-specific quality of life (CSQoL).

RESULTS: A total of 174 patients were included (response rate: 85.3%). Our exploratory severity scores revealed a strong symptom-consequence correlation (rs = 0.78). All symptom complexes demonstrated significant univariate associations between LARS consequence severity, bowel function satisfaction, and CSQoL (all P <.001), although "altered stool consistency" showed uniformly weak associations. Multivariate analysis identified 4 symptom complexes that remained independently associated with adverse consequences: "emptying difficulties" (B, 2.15 [95% CI, 1.16-3.14]; P <.001), "urgency" (B, 1.55 [95% CI, 0.62-2.48]; P =.001), "variable and unpredictable bowel function" (B, 1.46 [95% CI, 0.46-2.45]; P =.004), and "repeated painful stools" (B, 1.17 [95% CI, 0.45-1.89]; P =.002). In contrast, "altered stool consistency" exhibited a near-null independent association (B, -0.03 [95% CI, -0.88 to 0.82]; P =.944).

CONCLUSION: Of note, 4 specific symptom complexes, including "emptying difficulties," "urgency," "variable bowel function," and "repeated painful stools," were independently associated with adverse LARS consequences after ISR. However, "altered stool consistency" showed no such independent association, which warrants further investigation.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты