INTRODUCTION: Laparoscopic surgery has been established as a treatment method for patients with colorectal carcinoma. Thanks to the minimally invasive approach, patients with rectal carcinoma receive all the advantages of laparoscopic surgery without violating oncological principles.
Low anterior resection syndrome (LARS) is a symptom complex seen in patients operated on for rectal carcinoma. It includes the following symptoms: fecal incontinence, increased frequency of bowel movements or urgency of defecation, tenesmus. These symptoms can have a significant negative impact on the patient’s quality of life.
AIM: The purpose of this study is to determine the risk factors for the development of LARS and the degree of manifestation of this syndrome in different groups of patients.
MATERIALS AND METHODS: As inclusion criteria in the present study, we defined patients with histologically verified adenocarcinoma of the rectum. A retrospective analysis was made of 44 patients for the period of 2019–2023 operated on in the Prof. Alexander Stanishev Clinic of Surgery. In all patients, individual characteristics were considered: gender, age, accompanying diseases, performed non-adjuvant treatment, distant carcinoma from LAR, stage of the disease, and type of anastomosis performed. Exclusion criteria of the study were: unresectable carcinoma, patients operated conventionally, laparoscopy with conversion to laparotomy, amputation a.m. Miles.
RESULTS: From the conducted research regarding risk factors, the following were related: gender (women have a higher risk of developing major LARS); age (between 50–69 years with a higher risk of developing LARS); the distance of the carcinoma from the LAR (at 0–6 cm from the LAR—a higher risk for the development of major LARS); radiotherapy (higher risk of developing major LARS); concomitant diseases (in all patients with diabetes—manifestation of major LARS); the advanced stage of the disease (at T3 >= according to TNM—the risk of developing LARS is higher).
CONCLUSION: According to our study, risk factors for the development of LARS are: female gender, low location of the rectal carcinoma, conducted radiotherapy, diabetes mellitus, and advanced stage of the disease.
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