What you should know about the low anterior resection syndrome - Clinical recommendations from a patient perspective.

Autor: van der Heijden JAG; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: Joost.van.der.Heijden@mmc.nl., Thomas G; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: Gwen.Thomas@mmc.nl., Caers F; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: Freeke.Caers@mmc.nl., van Dijk WA; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: Williamvan.Dijk@mmc.nl., Slooter GD; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: G.Slooter@mmc.nl., Maaskant-Braat AJG; Department of Surgical Oncology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: sabrina.maaskant@mmc.nl.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2018 Sep; Vol. 44 (9), pp. 1331-1337. Date of Electronic Publication: 2018 May 16.
DOI: 10.1016/j.ejso.2018.05.010
Abstrakt: Introduction: Functional bowel complaints, referred to as Low Anterior Resection Syndrome (LARS), are common after sphincter-saving surgical procedures and have a severe impact on quality of life (QoL). Care for LARS patients is complex and surgeons underestimate or misinterpret its associated symptoms. This study aimed to explore the impact of LARS from a patient perspective facilitating the construction of a set of recommendations improving current care stratagems.
Methods: In a non-academic Dutch teaching hospital, three focus group sessions were conducted with 16 patients (males = 50%) who had undergone colorectal surgery between 2012 and 2017. A trained moderator orchestrated patient-discussion regarding illness perception and health-care needs. Transcripts were analysed using inductive content analysis.
Results: Three themes were identified: illness perception, preoperative care and postoperative supportive care. Specific attention and screening for LARS is deemed necessary for breaking the taboo surrounding it. Extension of preoperative counselling on the normal postoperative course, including ways to optimize social support, were identified as crucial. After discharge, patients experienced a lack of supportive care regarding functional complaints and did not know who to counsel. In addition, they felt intrinsically motivated to actively prepare for surgery, i.e. by participating in prehabilitation programs.
Conclusion: Exploring perspectives in LARS patients resulted in the identification of potential improvements in current care pathways. Recommendations on ways to improve information provision, screening of LARS and methods to intervene in the gap of supportive care after discharge are presented. We recommend to implement these measures as QoL of patients undergoing colorectal cancer surgery may be improved.
(Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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