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中华结直肠疾病电子杂志 ›› 2024, Vol. 13 ›› Issue (04) : 335 -340. doi: 10.3877/cma.j.issn.2095-3224.2024.04.010

综述

低位前切除综合征风险预测及治疗的研究进展
国超凡1, 彭琪博1, 郑章强2, 于向阳2,()   
  1. 1. 300000 天津医科大学南开临床学院;300100 天津市中西医结合医院胃肠外科
    2. 300100 天津市中西医结合医院胃肠外科
  • 收稿日期:2024-05-08 出版日期:2024-08-25
  • 通信作者: 于向阳
  • 基金资助:
    国家自然科学基金项目(92148201)

Risk prediction and treatment research advances of low anterior resection syndrome

Chaofan Guo1, Qibo Peng1, Zhangqiang Zheng2, Xiangyang Yu2,()   

  1. 1. Nankai Clinical College, Tianjin Medical University, Tianjin 300000, China;Department of Gastrointestinal Surgery, the Hospital of Integrated Chinese and Western Medicine, Tianjin 300100, China
    2. Department of Gastrointestinal Surgery, the Hospital of Integrated Chinese and Western Medicine, Tianjin 300100, China
  • Received:2024-05-08 Published:2024-08-25
  • Corresponding author: Xiangyang Yu
引用本文:

国超凡, 彭琪博, 郑章强, 于向阳. 低位前切除综合征风险预测及治疗的研究进展[J]. 中华结直肠疾病电子杂志, 2024, 13(04): 335-340.

Chaofan Guo, Qibo Peng, Zhangqiang Zheng, Xiangyang Yu. Risk prediction and treatment research advances of low anterior resection syndrome[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(04): 335-340.

低位前切除综合征(LARS)是一种常见的直肠癌术后并发症,发生率相对较高并且严重影响患者生存质量;目前很少有关于LARS的风险预测及治疗的系统研究论述;对于临床工作者来讲,掌握LARS的发生与发展规律及有效治疗手段有助于临床早干预及早治疗。本文就LARS的相关预测及治疗的研究进展进行综述。

The low anterior resection syndrome (LARS), a common postoperative complication of rectal cancer, has a relatively high incidence and seriously affects the quality of patient survival, and there are few systematic research studies addressing risk prediction and treatment of LARS. For clinicians, knowledge of the occurrence and progression of LARS and effective treatments are helpful for early clinical intervention and treatment. This article provides a review of research advances in the prediction and treatment related to LARS.

[1]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: Cancer J Clin, 2021, 71(3): 209-249.
[2]
Dekker E, Tanis PJ, Vleugels JLA, et al. Colorectal cancer[J]. Lancet(London, England), 2019, 394(10207): 1467-1480.
[3]
Pieniowski EH A, Palmer GJ, Juul T, et al. Low anterior resection syndrome and quality of life after sphincter-sparing rectal cancer surgery: a long-term longitudinal follow-up[J]. Dis Colon Rectum, 2019, 62(1): 14-20.
[4]
Kupsch J, Jackisch T, Matzel KE, et al. Outcome of bowel function following anterior resection for rectal cancer-an analysis using the low anterior resection syndrome (LARS) score[J]. Int J Colorectal Dis, 2018, 33(6): 787-798.
[5]
岳德亮, 王道岭, 刘宇, 等. 直肠癌经肛全直肠系膜切除术后生活质量变化及低位前切除综合征发生风险分析[J]. 肿瘤学杂志, 2022, 28(4): 310-314.
[6]
Kang DH. Low anterior resection syndrome: is it predictable?[J]. Ann Coloproctol, 2023, 39(5): 373-374.
[7]
Ye L, Huang M, Huang Y, et al. Risk factors of postoperative low anterior resection syndrome for colorectal cancer: a meta-analysis [J]. Asian J Surg, 2022, 45(1): 39-50.
[8]
袁野, 常剑, 刘冬波, 等. 腹腔镜直肠癌保肛术后低位前切除综合征转归的影响因素分析[J]. 中国肛肠病杂志, 2021, 41(1): 12-14.
[9]
He S, Zhang J, Wang R, et al. Impact of long-course neoadjuvant radiation on postoperative low anterior resection syndrome and stoma status in rectal cancer: long-term functional follow-up of a randomized clinical trial [J]. BJS Open, 2022, 6(6): zrac127.
[10]
骆洋, 何承祥, 敬然, 等. 腹腔镜低位直肠癌手术中肠系膜下动脉高位结扎和低位结扎对低位前切除综合征影响研究[J]. 中国实用外科杂志, 2022, 42(3): 320-325.
[11]
Battersby NJ, Bouliotis G, Emmertsen KJ, et al. Development and external validation of a nomogram and online tool to predict bowel dysfunction following restorative rectal cancer resection: the POLARS score [J]. Gut, 2018, 67(4): 688-696.
[12]
Bogacki P, Krzak J, Gach T, et al. Can the POLARS tool accurately predict low anterior resection syndrome in rectal cancer patients undergoing laparoscopic resection?[J]. Arch Med Sci, 2023, 19(2): 365-370.
[13]
Rethy B, Nordenvall C, Pieniowski E, et al. Validity assessment of the POLARS score tool in the prediction of post rectal cancer surgery LARS score in a population-based Swedish cohort[J]. BMJ Open Gastroenterology, 2024, 11(1): e001274.
[14]
Yan M, Lin Z, Wu Z, et al. A predictive nomogram model for low anterior resection syndrome after rectal cancer resection [J]. ANZ J Surg, 2022, 92(12): 3224-3231.
[15]
Xia F, Zou Y, Zhang Q, et al. A novel nomogram to predict low anterior resection syndrome (LARS) after ileostomy reversal for rectal cancer patients [J]. Eur J Surg Oncol, 2023, 49(2): 452-460.
[16]
Paku M, Miyoshi N, Fujino S, et al. Development and evaluation of a Japanese prediction model for low anterior resection syndrome after rectal cancer surgery [J]. BMC Gastroenterol, 2022, 22(1): 239.
[17]
Huang MJ, Ye L, Yu KX, et al. Development of prediction model of low anterior resection syndrome for colorectal cancer patients after surgery based on machine-learning technique[J]. Cancer Medicine, 2023, 12(2): 1501-1519.
[18]
Wang Z, Shao SL, Liu L, et al. Machine learning model for prediction of low anterior resection syndrome following laparoscopic anterior resection of rectal cancer: A multicenter study[J]. World J Gastroenterol, 2023, 29(19): 2979-2991.
[19]
Qin Q, Huang B, Wu A, et al. Development and validation of a post-radiotherapy prediction model for bowel dysfunction after rectal cancer resection[J]. Gastroenterology, 2023, 165(6): 1430-1442.e14.
[20]
Brock H, Lambrineas L, Ong HI, et al. Preventative strategies for low anterior resection syndrome[J]. Tech Coloproctol, 2023, 28(1): 10.
[21]
Staller K, Song M, Grodstein F, et al. Increased long-term dietary fiber intake is associated with a decreased risk of fecal incontinence in older women[J]. Gastroenterology, 2018, 155(3): 661-667.e1.
[22]
Yoon BJ, Oh HK, Lee J, et al. Effects of probiotics on bowel function restoration following ileostomy closure in rectal cancer patients: a randomized controlled trial[J]. Colorectal Dis, 2021, 23(4): 901-910.
[23]
Rosen H, Sebesta CG, Sebesta C. Management of low anterior resection syndrome (LARS) following resection for rectal cancer[J]. Cancers, 2023, 15(3): 778.
[24]
Ryoo SB, Park JW, Lee DW, et al. Anterior resection syndrome: a randomized clinical trial of a 5-HT3 receptor antagonist (ramosetron) in male patients with rectal cancer[J]. Br J Surg, 2021, 108(6): 644-651.
[25]
Popeskou SG, Roesel R, Faes S, et al. Ondansetron for low anterior resection syndrome(LARS): a double-blind, placebo-controlled, cross-over, randomized study[J]. Ann Surgery, 2024, 279(2): 196-202.
[26]
Savarino E, Zingone F, Barberio B, et al. Functional bowel disorders with diarrhoea: clinical guidelines of the united european gastroenterology and european society for neurogastroenterology and motility[J]. United European Gastroenterol J, 2022, 10(6): 556-584.
[27]
Martellucci J, Sturiale A, Bergamini C, et al. Role of transanal irrigation in the treatment of anterior resection syndrome[J]. Tech Coloproctol, 2018, 22(7): 519-527.
[28]
Rosen H, Robert-Yap J, Tentschert G, et al. Transanal irrigation improves quality of life in patients with low anterior resection syndrome[J]. Colorectal Dis, 2011, 13(10): e335-338.
[29]
Dale M, Morgan H, Carter K, et al. Peristeen transanal irrigation system to manage bowel dysfunction: a NICE medical technology guidance[J]. Appl Health Econ Health Policy, 2019, 17(1): 25-34.
[30]
Mekhael M, Kristensen H, Larsen HM, et al. Transanal irrigation for neurogenic bowel disease, low anterior resection syndrome, faecal incontinence and chronic constipation: a systematic review[J]. J Clin Med, 2021, 10(4): 753.
[31]
Pieniowski EHA, Bergström CM, Nordenvall CAM, et al. A randomized controlled clinical trial of transanal irrigation versus conservative treatment in patients with low anterior resection syndrome after rectal cancer surgery [J]. Ann Surg, 2023, 277(1): 30-37.
[32]
Meurette G, Faucheron JL, Cotte E, et al. Low anterior resection syndrome after rectal resection management: multicentre randomized clinical trial of transanal irrigation with a dedicated device (cone catheter) versus conservative bowel management [J]. Br J Surg, 2023, 110(9): 1092-1095.
[33]
李兴旺, 胡军红. 直肠癌术后前切除综合征的研究进展[J/OL]. 中华结直肠疾病电子杂志, 2019, 8(2): 170-175.
[34]
Allgayer H, Dietrich CF, Rohde W, et al. Prospective comparison of short- and long-term effects of pelvic floor exercise/biofeedback training in patients with fecal incontinence after surgery plus irradiation versus surgery alone for colorectal cancer: clinical, functional and endoscopic/endosonographic findings[J]. Scand J Gastroenterol, 2005, 40(10): 1168-1175.
[35]
Visser WS, Te Riele WW, Boerma D, et al. Pelvic floor rehabilitation to improve functional outcome after a low anterior resection: a systematic review [J]. Ann Coloproctology, 2014, 30(3): 109-114.
[36]
Lin YH, Yang HY, Hung SL, et al. Effects of pelvic floor muscle exercise on faecal incontinence in rectal cancer patients after stoma closure [J]. Eur J Cancer Care (Engl), 2016, 25(3): 449-457.
[37]
Asnong A, D'Hoore A, Van Kampen M, et al. The role of pelvic floor muscle training on low anterior resection syndrome: a multicenter randomized controlled trial[J]. Ann Surg, 2022, 276(5): 761-768.
[38]
吴晓丹, 符春凤, 陈依琳, 等. 生物反馈联合盆底肌锻炼对直肠癌低位保肛患者低位前切除综合征的作用[J]. 中华医学杂志, 2019, 99(30): 2337-2343.
[39]
Cho HM, Kim H, Yoo R, et al. Effect of biofeedback therapy during temporary stoma period in rectal cancer patients: a prospective randomized trial[J]. J Clin Med, 2021, 10(21): 5172.
[40]
Martellucci J. Low anterior resection syndrome: a treatment algorithm[J]. Dis Colon Rectum, 2016, 59(1): 79-82.
[41]
Sacomori C, Lorca LA, Martinez-Mardones M, et al. A randomized clinical trial to assess the effectiveness of pre- and post-surgical pelvic floor physiotherapy for bowel symptoms, pelvic floor function, and quality of life of patients with rectal cancer: CARRET protocol[J]. Trials, 2021, 22(1): 448.
[42]
Eftaiha SM, Balachandran B, Marecik SJ, et al. Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome[J]. Colorectal Dis, 2017, 19(10): 927-933.
[43]
Rubio-Perez I, Saavedra J, Marijuan JL, et al. Optimizing sacral neuromodulation for low anterior resection syndrome: learning from our experience[J]. Colorectal Dis, 2020, 22(12): 2146-2154.
[44]
Marinello F, Fraccalvieri D, Planellas P, et al. Sacral neuromodulation in patients with low anterior resection syndrome: the SANLARS randomized clinical trial[J]. Dis Colon Rectum, 2024, 67(3): 435-447.
[45]
Enriquez-Navascues JM, Labaka-Arteaga I, Aguirre-Allende I, et al. A randomized trial comparing transanal irrigation and percutaneous tibial nerve stimulation in the management of low anterior resection syndrome[J]. Colorectal Dis, 2020, 22(3): 303-309.
[46]
Huang Y, Koh CE. Sacral nerve stimulation for bowel dysfunction following low anterior resection: a systematic review and meta-analysis[J]. Colorectal Dis, 2019, 21(11): 1240-1248.
[47]
任佳慧, 沈云天, 杜昆利, 等. 针刺八髎穴联合生物反馈治疗直肠癌术后低位直肠前切除综合征疗效研究[J]. 陕西中医, 2022, 43(6): 781-784.
[48]
赵加应, 殷琛庆, 陈文杰, 等. 针灸联合生物反馈治疗直肠癌保肛术后排便失禁的效果[J]. 中国康复理论与实践, 2020, 26(6): 715-724.
[49]
Zhang L, Hu C, Zhao J, et al. The effect of robotic surgery on low anterior resection syndrome in patients with lower rectal cancer: a propensity score-matched analysis[J]. Surgical endoscopy, 2024, 38(4): 1912-1921.
[50]
Duggan WP, Sugrue DD, Shannon N, et al. A prospective evaluation of the effect of transanal minimally invasive surgery (TAMIS) on low anterior resection syndrome[J]. Surg Endosc, 2023, 37(7): 5241-5245.
[51]
Qin H, Meng L, Huang Z, et al. A study on the clinical application of greater omental pedicle flap transplantation to correct anterior resection syndrome in patients with low rectal cancer [J]. Regen Ther, 2021, 18: 146-151.
[52]
Kang SB, Cho JR, Jeong SY, et al. Quality of life after sphincter preservation surgery or abdominoperineal resection for low rectal cancer (ASPIRE): A long-term prospective, multicentre, cohort study[J]. Lancet Reg Health West Pac, 2021, 6: 100087.
[53]
Harji D, Fernandez B, Boissieras L, et al. A novel bowel rehabilitation programme after total mesorectal excision for rectal cancer: the BOREAL pilot study[J]. Colorectal Dis, 2021, 23(10): 2619-2626.
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