Analysis of Related Factors Affecting the Occurrence of LARS After Anal Conserving Radical Surgery for Rectal Cancer

Zhang Fangdi; Wan Xue; Yan Xuenan

doi:10.3969/j.issn.1004-5775.2025.07.006

Abstract：Objective:To investigate the high risk factors of low anterior resection syndrome(LARS)after laparoscopic anal saving surgery for rectal cancer.Methods:The clinical data of 77 patients who were successfully discharged from the hospital after laparoscopic anal preserving radical resection for rectal cancer from January 2019 to December 2023 were retrospectively analyzed.In the follow-up process,patients were divided into the LARS group and the LARS group without LARS according to whether they had LARS.The data of underlying diseases and clinical indicators of the two groups were analyzed and compared,and the items with differences in test were included in logistics regression analysis to obtain the independent risk factors of LARS complicated after laparoscopic anal preservation radical surgery for rectal cancer.Results:The incidence rates of BMI≥24 kg/m2,tumor distance from anal margin ≤7 cm,neoadjuvant chemotherapy,anastomotic fistula,and postoperative recovery time ≤6 months in LARS group were higher than those in no LARS group,with statistically significant difference(x2=5.427,8.920,12.585,10.073,5.898;P＜0.05).Logsitic regression analysis results show that BMI≥24 kg/m2,tumor distance from anal margin≤7 cm,neoadjuvant chemotherapy,anastomotic fistula,and postoperative recovery time ≤6 months were the risk factors for LARS after laparoscopic anal preservation for rectal cancer(OR=3.048,4.267,5.867,4.838,3.200;P＜0.05).Conclusion:The risk of LARS after laparoscopic anal preservation for rectal cancer is very high,which is related to obesity or overweight patients,tumor distance from anal margin,neoadjuvant chemotherapy,anastomotic fistula,and short postoperative recovery time.Clinical intervention measures can be taken early according to the above factors.