Refractory major LARS: stoma can wait
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We read with interest Dulskas’ article entitled “Treatment possibilities for low anterior resection syndrome: a review of the literature” . The author provides an analysis of possible treatment options for low anterior resection syndrome (LARS) after colorectal sphincter-preserving surgery, considering in detail results found in the literature. The need of awareness of this important subject is not trivial: a recent meta-analysis  has detected an estimated prevalence of major LARS of 41% (95% CI 34–48) at 1 year after surgery, and a multi-institutional survey  has shown how knowledge of therapeutic options is limited because about half of surgeons have only experience with dietary and drug treatment modalities.
From Dulskas’ review, it seems clear that the current therapeutic leanings are toward conservative treatments or minimally invasive procedures according to the predominant symptoms. However, although decision-making algorithms  are very useful in the...
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