Impact of low anterior resection syndrome after rectal surgery on sleep quality.

PURPOSE: The factors contributing to the association between rectal cancer and sleep impairment remain unclear. We investigated the risk factors for sleep impairment after anus-preserving surgery for rectal cancer.

METHODS: This cross-sectional study investigated surviving patients who underwent low anterior or intersphincteric resection with curative intent for rectal cancer located < 15 cm from the anal verge. Defecatory dysfunction and sleep quality were assessed using the low anterior resection syndrome (LARS) score and the Pittsburgh Sleep Quality Index, respectively.

RESULTS: A total of 176 patients were included in this analysis. The sleep impairment rate in the "major LARS" group was significantly higher than that in the "no/minor LARS" group (54.5 vs. 24.2%; p < 0.001). Multivariable analysis identified that age (odds ratio = 0.943) and tumor height (odds ratio = 0.893) were independently associated with major LARS. In the multivariable analysis for sleep impairment, major LARS (odds ratio = 4.490, p < 0.001) and adjuvant (pre/post) chemotherapy (odds ratio = 3.400, p = 0.003) were independently associated with sleep impairment.

CONCLUSION: Sleep quality was reduced significantly in patients with major LARS after rectal cancer surgery. Adjuvant chemotherapy also impairs sleep quality, while low tumor location and young age were independent risk factors for major LARS.