Distinct trajectories of low anterior resection syndrome following ileostomy reversal
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By
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Xuena Zhang
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Qingyu Meng
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Jingru Wang
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Simeng Jiang
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Zhongtao Tian
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Zihan Fan
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Tong Wang
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Wenbo Niu
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June 30, 2026
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Clinical Scorecard: Diverse Patterns of Low Anterior Resection Syndrome After Reversal of Ileostomy
At a Glance
| Category | Detail |
|---|
| Condition | Low Anterior Resection Syndrome (LARS) |
| Key Mechanisms | Postoperative functional impairments characterized by fecal incontinence, urgency, and increased bowel frequency. |
| Target Population | Rectal cancer patients who underwent low anterior resection with diverting ileostomy and subsequent reversal. |
| Care Setting | Postoperative assessment in a clinical setting. |
Key Highlights
- Three LARS symptom trajectories identified: mild and recovering (30.6%), moderate and fluctuating (40.3%), severe and persistent (29.1%).
- Significant differences in symptom severity observed among the three groups at all time points (P < 0.001).
- Higher T stage, lower anastomotic height, and receipt of preoperative radiotherapy associated with worse trajectories.
Guideline-Based Recommendations
Diagnosis
- Utilize LARS scores to assess postoperative bowel dysfunction.
Management
- Consider pharmacological therapy, biofeedback training, and sacral nerve stimulation for LARS.
Monitoring & Follow-up
- Regular follow-up assessments at 3, 6, 9, and 12 months postoperatively.
Risks
- Preoperative radiotherapy, low anastomotic height, and advanced tumor stage increase the probability of severe LARS.
Patient & Prescribing Data
134 rectal cancer patients treated at the Fourth Hospital of Hebei Medical University.
Only a small proportion of patients receive interventions for LARS despite their potential benefits.
Clinical Best Practices
- Recognize the heterogeneous patterns of LARS symptom trajectories for personalized postoperative care.
- Implement early tailored interventions based on identified risk factors.
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