The risk factors of low anterior resection syndrome and its influence on psychological status and quality of life in rectal cancer patients / 中华普通外科杂志

ABSTRACT

Objective:To investigate the effects of low anterior resection syndrome (LARS) on psychological and physical function and quality of life in patients with rectal cancer.Methods:From May 2014 to May 2019, 200 patients were included. LARS scale score was adopted, and the clinical and pathological data were collected. Univariate analysis and multivariate Logistic regression analysis were performed. the European Organization for Research and Treatment of Cancer Quality of Life core questionnaire and psychological distress management screening tool survey were conducted to evaluate the quality of life and psychological state. The incidence of postoperative sexual dysfunction in male patients was analyzed.Results:The incidence of LARS was 43.0%. Multivariate analysis showed that body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance ≤5 cm from anal margin, and preoperative radiotherapy were independent risk factors for LARS ( OR=2.123, 15.109, 7.302, 12.682, all P<0.05).The overall health level and the scores of physical function and emotional function in the functional dimension of patients in the severe LARS group were significantly lower than those in the no/mild LARS group ( t=5.788, 8.831, 8.745, all P<0.05). The scores of fatigue and diarrhea were significantly higher than those in the no/mild LARS group ( t=26.280, 49.476, all P<0.05). The psychological distress thermometer score and the scores of communication , emotional and physical problems in the severe LARS group were significantly higher than those in the no/mild LARS group ( t=4.246, 6.563, 5.913, 4.408, all P<0.05). Conclusion:LARS is a common complication after Dixon procedure for rectal cancer. Body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance from anal margin ≤5 cm, and preoperative radiotherapy are independent risk factors for LARS.