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

Autor: Gwendolyn Thomas, J.A.G. van der Heijden, A. J.G. Maaskant-Braat, Gerrit D. Slooter, W.A. van Dijk, F. Caers
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
media_common.quotation_subject
Prehabilitation
Preoperative care
03 medical and health sciences
Social support
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
0302 clinical medicine
Quality of life (healthcare)
All institutes and research themes of the Radboud University Medical Center
Postoperative Complications
Surveys and Questionnaires
Medicine
Humans
Digestive System Surgical Procedures
media_common
Aged
Netherlands
Retrospective Studies
business.industry
Rectal Neoplasms
Incidence
Taboo
General Medicine
Syndrome
Moderation
Focus group
Colorectal surgery
Oncology
030220 oncology & carcinogenesis
Family medicine
Quality of Life
030211 gastroenterology & hepatology
Surgery
Female
business
Fecal Incontinence
Follow-Up Studies
Zdroj: European Journal of Surgical Oncology, 44, 1331-1337
European Journal of Surgical Oncology, 44, 9, pp. 1331-1337
ISSN: 0748-7983
Popis: 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.
Databáze: OpenAIRE
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