Presentation Information
[INTS2-4]Determinants of Low Anterior Resection Syndrome: Impact of Surgical Technique and Chemotherapy in Rectal Cancer — A Single-Center Study
*Alan Jasqui Bucay1, María Dolores Hernández Gomez1, Andrés Herrera Pineda1, Ulises Pérez Escobedo1, Agustín Güemes Quinto1, Luis Enrique Bolaños Badillo1, Eduardo Alvarado Tamez1, Gisela Giovanna Oropeza Rodríguez1, Jeziel Karina Ordoñez Juárez1, Juan Antonio Villanueva Herrero1, Billy Jiménez Bobadilla1 (1. Hospital General de México, México)
Determinants of Low Anterior Resection Syndrome: Impact of Surgical Technique and Chemotherapy in Rectal Cancer — A Single-Center Study
Introduction:
Low anterior resection syndrome (LARS) is a common complication following rectal cancer surgery, characterized by urgency, increased stool frequency, and fecal incontinence, with a significant impact on quality of life. Its pathophysiology is multifactorial and may be influenced by both surgical technique and oncologic treatment strategies.
Methods:
A retrospective cohort study was conducted including patients with histopathological diagnosis of rectal cancer who underwent low anterior resection (LAR), ultra-low anterior resection (uLAR), or abdominoperineal resection (APR) at a tertiary referral center between January 2024 and December 2025. Patients <18 years or without at least 12 months of follow-up were excluded. Demographic, clinical, and treatment variables—including neoadjuvant, adjuvant, or combined chemotherapy—were analyzed. Associations with LARS were assessed using Fisher’s exact test.
Results:
A total of 98 patients were included (mean age 56.1 years; 44.9% female). Seven patients (7.14%) developed LARS. No statistically significant association was observed between chemotherapy exposure—neoadjuvant, adjuvant, or combined—and the development of LARS (p > 0.05). The incidence of LARS was similar between patients with and without neoadjuvant therapy (7.8% vs. 8.3%; p = 1.000).
In contrast, LARS occurred more frequently in patients undergoing uLAR compared to LAR (11.4% vs. 4.5%), although this difference did not reach statistical significance (p = 0.43).
Conclusions:
Chemotherapy exposure was not associated with the development of LARS in this cohort. A higher incidence observed following uLAR suggests that surgical technique and extent of pelvic dissection may play a more relevant role in postoperative bowel dysfunction. These findings, although limited by the low number of events, are consistent with known pathophysiological mechanisms and warrant further investigation in larger studies.
Introduction:
Low anterior resection syndrome (LARS) is a common complication following rectal cancer surgery, characterized by urgency, increased stool frequency, and fecal incontinence, with a significant impact on quality of life. Its pathophysiology is multifactorial and may be influenced by both surgical technique and oncologic treatment strategies.
Methods:
A retrospective cohort study was conducted including patients with histopathological diagnosis of rectal cancer who underwent low anterior resection (LAR), ultra-low anterior resection (uLAR), or abdominoperineal resection (APR) at a tertiary referral center between January 2024 and December 2025. Patients <18 years or without at least 12 months of follow-up were excluded. Demographic, clinical, and treatment variables—including neoadjuvant, adjuvant, or combined chemotherapy—were analyzed. Associations with LARS were assessed using Fisher’s exact test.
Results:
A total of 98 patients were included (mean age 56.1 years; 44.9% female). Seven patients (7.14%) developed LARS. No statistically significant association was observed between chemotherapy exposure—neoadjuvant, adjuvant, or combined—and the development of LARS (p > 0.05). The incidence of LARS was similar between patients with and without neoadjuvant therapy (7.8% vs. 8.3%; p = 1.000).
In contrast, LARS occurred more frequently in patients undergoing uLAR compared to LAR (11.4% vs. 4.5%), although this difference did not reach statistical significance (p = 0.43).
Conclusions:
Chemotherapy exposure was not associated with the development of LARS in this cohort. A higher incidence observed following uLAR suggests that surgical technique and extent of pelvic dissection may play a more relevant role in postoperative bowel dysfunction. These findings, although limited by the low number of events, are consistent with known pathophysiological mechanisms and warrant further investigation in larger studies.