Advertisement

Refractory major LARS: stoma can wait

  • Roberto PeltriniEmail author
  • Paola Antonella Greco
  • Luigi Bucci
Letter to the Editor
  • 1 Downloads

Dear Editor:

We read with interest Dulskas’ article entitled “Treatment possibilities for low anterior resection syndrome: a review of the literature” [1]. 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 [2] has detected an estimated prevalence of major LARS of 41% (95% CI 34–48) at 1 year after surgery, and a multi-institutional survey [3] 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 [4] are very useful in the...

Notes

References

  1. 1.
    Dulskas A, Smolskas E, Kildusiene I, Samalavicius NE (2018) Treatment possibilities for low anterior resection syndrome: a review of the literature. Int J Color Dis 33(3):251–260CrossRefGoogle Scholar
  2. 2.
    Croese AD, Lonie JM, Trollope AF, Vangaveti VN, Ho YH (2018) A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg 56:234–241CrossRefGoogle Scholar
  3. 3.
    Jimenez-Gomez LM, Espin-Basany E, Marti-Gallostra M, Sanchez-Garcia JL, Vallribera-Valls F, Armengol-Carrasco M (2016) Low anterior resection syndrome: a survey of the members of the American Society of Colon and Rectal Surgeons (ASCRS), the Spanish Association of Surgeons (AEC), and the Spanish Society of Coloproctology (AECP). Int J Color Dis 31(4):813–823CrossRefGoogle Scholar
  4. 4.
    Martellucci J (2016) Low anterior resection syndrome: a treatment algorithm. Dis Colon Rectum 59(1):79–82CrossRefGoogle Scholar
  5. 5.
    Martellucci J, Sturiale A, Bergamini C, Boni L, Cianchi F, Coratti A, Valeri A (2018) Role of transanal irrigation in the treatment of anterior resection syndrome. Tech Coloproctol 22(7):519–527CrossRefGoogle Scholar
  6. 6.
    Didailler R et al (2018) Antegrade enema after total Mesorectal excision for rectal cancer: the last chance to avoid definitive colostomy for refractory low anterior resection syndrome and fecal incontinence. Dis Colon Rectum 61(6):667–672Google Scholar
  7. 7.
    Ricard J, Quénéhervé L, Lefevre C, le Rhun M, Chabrun E, Duchalais-Dassonneville E, Meurette G, Touchefeu Y, Bruley des Varannes S, Zerbib F, Coron E (2019) Anterograde colonic irrigations by percutaneous endoscopic caecostomy in refractory colorectal functional disorders. Int J Color Dis 34:169–175CrossRefGoogle Scholar
  8. 8.
    Patel AS, Saratzis A, Arasaradnam R, Harmston C (2015) Use of antegrade continence enema for the treatment of fecal incontinence and functional constipation in adults: a systematic review. Dis Colon Rectum 58(10):999–1013CrossRefGoogle Scholar
  9. 9.
    Chan DSY, Delicata RJ (2016) Meta-analysis of antegrade continence enema in adults with faecal incontinence and constipation. Br J Surg 103(4):322–327CrossRefGoogle Scholar
  10. 10.
    Patton V, Lubowski DZ (2015) Clinical outcome and efficacy of antegrade colonic enemas administered via an indwelling cecostomy catheter in adults with defecatory disorders. Dis Colon Rectum 58(4):457–462CrossRefGoogle Scholar
  11. 11.
    Pucciani F (2013) A review on functional results of sphincter-saving surgery for rectal cancer: the anterior resection syndrome. Updat Surg 65(4):257–263CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General and Specialist SurgeryUniversity of Naples Federico IINaplesItaly

Personalised recommendations