Objectives: The aim of the study was to assess the diagnosis and evolution of low anterior rectal resection syndrome (LARS) in patients admitted to a tertiary surgical center in Romania. Materials and Methods: From 120 patients initially included in the analysis, after applying the exclusion criteria, we selected 102 patients diagnosed and operated on for neoplasm of the upper, middle, and lower rectum for which resection and excision (partial or total) of mesorectum was associated. All the patients we treated in the general surgery department of the County Emergency Hospital of Craiova within a time frame of 5 years (1 October 2017–1 September 2022), and all experienced at least one symptom associated with LARS. The group included 68 men and 34 women aged between 35 and 88, who were followed-up for at least 2 years. Patients with progression of neoplastic disease, with advanced neurological disease, and those who died less than 2 years after surgery were excluded. Results: The overall incidence varied by gender, site of the tumor (requiring a certain type of surgery), and anastomotic complications, and it was directly proportional to the time interval between resection and restoration of continuity of digestion. Conclusions: Obesity, size of the remaining rectum, total excision of the mesorectum, anastomotic complications, and prolonged ileostomy time are cofactors in the etiology of LARS. The LARS score decreased in most patients during the 2-year follow-up, although there were a small number of patients in whom the decrease was insignificant. The persistence of major LARS at 6 months after surgery may predict the need for a definitive colostomy.
目的：本研究旨在评估罗马尼亚一家三级外科中心收治患者中低位前直肠切除综合征（LARS）的诊断与演变情况。材料与方法：研究初始纳入120例患者，经排除标准筛选后，最终纳入102例确诊并接受手术治疗的直肠上、中、下段肿瘤患者，所有病例均联合实施了直肠系膜部分或全部切除手术。这些患者均于2017年10月1日至2022年9月1日期间在克拉约瓦县急救医院普外科接受治疗，且均出现至少一种LARS相关症状。研究组包括68名男性和34名女性，年龄介于35至88岁之间，所有患者均接受至少2年随访。排除标准包括肿瘤进展、晚期神经系统疾病及术后生存期不足2年的患者。结果：总体发病率受性别、肿瘤位置（决定手术类型）及吻合口并发症等因素影响，并与消化道连续性重建手术的时间间隔呈正相关。结论：肥胖、残余直肠长度、直肠系膜全切除、吻合口并发症及回肠造口时间延长是LARS发病的协同因素。在两年随访期间，大多数患者的LARS评分有所下降，但少数患者改善不明显。术后6个月持续存在重度LARS可能预示需要永久性结肠造口术。
肿瘤(癌症)患者之家