Predictive factors of low anterior resection syndrome following anterior resection of the rectum.

Autor:	Miacci FLC; Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Coloproctologia, Curitiba, PR, Brasil., Guetter CR; Universidade Federal do Paraná, Centro de Ciências da Saúde, Curso de Medicina, Curitiba, PR, Brasil., Moreira PH; Universidade Federal do Paraná, Centro de Ciências da Saúde, Curso de Medicina, Curitiba, PR, Brasil., Sartor MC; Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Coloproctologia, Curitiba, PR, Brasil., Savio MC; Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Coloproctologia, Curitiba, PR, Brasil., Baldin Júnior A; Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Coloproctologia, Curitiba, PR, Brasil., Nóbrega NL; Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Coloproctologia, Curitiba, PR, Brasil.
Jazyk:	Portuguese; English
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2020 Jan 31; Vol. 46 (6), pp. e20192361. Date of Electronic Publication: 2020 Jan 31 (Print Publication: 2020).
DOI:	10.1590/0100-6991e-20192361
Abstrakt:	Objective: to identify predictors of low anterior resection syndrome (LARS) that can contribute to its early diagnosis and treatment. Methods: we conducted a retrospective cohort study of patients undergoing anterior resection of the rectum between 2007 and 2017 in the Coloproctology Service of the Federal University of Parana Clinics Hospital. We performed Receiver Operating Characteristic Curve (ROC) analysis to identify LARS predictive factors. Results: we included 64 patients with complete data. The men's age was 60.1±11.4 years and 37.10% were male. Twenty patients (32.26%) had LARS. The most reported symptoms were incomplete evacuation (60%) and urgency (55%). In the univariate analysis, the distance from the anastomosis to the anal margin (p<0.001), neoadjuvant therapy (p=0.0014) and ileostomy at the time of resection (p=0.0023) were predictive of LARS. The ROC curve analysis showed a 6.5cm cut-off distance from the anastomosis to the anal margin as a predictor of LARS. Conclusion: distance between the anastomosis and the anal margin, neoadjuvant therapy history and preparation of stoma are conditions that can help predict the development of LARS. Guidance and involvement in patient education, as well as early management, can potentially reduce the impact of these symptoms on patients' quality of life.
Databáze:	MEDLINE
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