Low anterior resection syndrome score - development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer: OP02


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Abstract

Aim:Low anterior resection for rectal cancer often results in severe bowel dysfunction [Low Anterior Resection Syndrome (LARS)] with incontinence, urgency and frequent bowel movements. Several studies have investigated functional outcome, but the terminology is inconsistent hereby complicating comparison of results. The aim of this study was to develop and validate a scoring system based on symptoms and impact on quality of life (QoL).Method:Questionnaires to 1212 patients. Associations between items and QoL were computed by binomial regression analyses. The important items were selected and regression analysis was performed to find the adjusted risk ratios. Individual score values were designated items to form the LARS-score which was divided into ‘No LARS’, ‘Minor LARS’ and ‘Major LARS’. Validity was tested by ROC curve and Spearman's rank correlation.Results:One thousand and twenty patients responded. The five most important items were: ‘Incontinence for flatus’, ‘Soiling’, ‘Frequency’, ‘Clustering’ and ‘Urgency’. Range: 0-42, divided into 0-20 (No LARS), 21-29 (Minor LARS) and 30-42 (Major LARS). The score showed good correlation and a high sensitivity (72.54%) and specificity (82.52%) for Major LARS.Conclusion:We have constructed a valid and reliable LARS-score correlated to QoL — a simple tool for quick clinical evaluation of the severity of LARS

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