Low anterior resection syndrome after right- and left-sided resections for colonic cancer

Background: This population-based cohort study aimed to evaluate occurrence of low anterior resection syndrome (LARS) and correlate this to health-related quality of life in patients who had undergone segmental colonic resection for colonic cancer in the Stockholm-Gotland region. The hypothesis was that there is a difference in occurrence of LARS depending on whether a right- or a left-sided resection was performed. Methods: Patients who underwent segmental colonic resection for colonic cancer stages I-III in the Stockholm-Gotland region in 2013-2015 received EORTC QLQ-C30, QLQ-CR29 and LARS score questionnaires 1year after surgery. Clinical patient and tumour data were collected from the Swedish ColoRectal Cancer Registry. Patient-reported outcome measures were analysed in relation to type of colonic resection. Results: Questionnaires were sent to 866 patients and complete responses were provided by 517 (59.7 per cent). After right-sided resection 20.6 per cent reported major LARS. After left-sided resection the proportion with major LARS was 15.6 per cent. The odds ratio (OR) for major LARS after right-sided resection was 1.45 (95 per cent c.i. 1.02 to 2.06; P = 0.037) compared with left-sided resection. After adjustment for age and sex, an increase in the risk of major LARS after right- versus left-sided resection remained (OR 1.48, 1.03 to 2.13; P = 0.035). Major LARS correlated with impaired quality of life. Conclusion: Major LARS was more frequent after right-sided than following left-sided colonic resection. Major LARS reflected impaired quality of life.