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Sacral neurostimulation for low anterior resection syndrome after radical resection for rectal cancer: evaluation of treatment with the LARS score

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Abstract

Purpose

Sacral neurostimulation (SNS) has proven to be an effective treatment modality for low anterior resection syndrome (LARS). The primary aim of this study is to investigate the impact of SNS on all symptoms of LARS, not merely on fecal incontinence. Furthermore, we wanted to evaluate whether the LARS score could be useful as a tool to evaluate SNS treatment.

Methods

All patients diagnosed with minor or major LARS, unresponsive to conservative therapy for fecal incontinence, who underwent sacral neuromodulation for LARS at Groeninge Hospital, Kortrijk, Belgium, were prospectively enrolled in the study. The primary endpoint was the reduction in the severity of LARS. This was assessed by validated questionnaires: the LARS score and the Wexner score.

Results

Eleven patients underwent definite implantation of the SNS device. All patients showed a substantial decrease in their Wexner scores: The mean score was reduced from 17.7 to 4.6 (Z: 2.93; p: 0.0033). Additionally, the mean LARS score dropped from 36.9 to 11.4 (Z: 2.93; p: 0.0033). Furthermore, there was a significant amelioration of all symptoms of LARS.

Conclusions

Our study shows that SNS is effective for all symptoms of LARS. The authors believe that in patients who receive SNS for LARS, it could be useful to determine the LARS score to evaluate the complexity of the symptoms and their response to treatment.

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Authors and Affiliations

  1. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium

    M. D’Hondt & F. Nuytens

  2. Department of Oncology and Statistics, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium

    I. Parmentier

  3. Faculty of Medicine, KU Leuven, Leuven, Belgium

    L. Kinget & M. Decaestecker

  4. Faculty of Medicine and Health Sciences, UGent, De Pintelaan 135, 9000, Ghent, Belgium

    B. Borgers

Authors
  1. M. D’Hondt
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  2. F. Nuytens
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  3. L. Kinget
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  4. M. Decaestecker
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  5. B. Borgers
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  6. I. Parmentier
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Corresponding author

Correspondence to M. D’Hondt.

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Conflict of interest

None of the authors have potential and real conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All patients undergoing the PNE or SNS procedure provided informed consent.

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D’Hondt, M., Nuytens, F., Kinget, L. et al. Sacral neurostimulation for low anterior resection syndrome after radical resection for rectal cancer: evaluation of treatment with the LARS score. Tech Coloproctol 21, 301–307 (2017). https://doi.org/10.1007/s10151-017-1612-1

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  • DOI: https://doi.org/10.1007/s10151-017-1612-1

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