Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study
Abstract Background The etiology of LARS has not been elaborated on clearly. Studies have reported neoadjuvant therapy, low-lying rectal cancers, adjuvant therapy and anastomotic leakage as risk factors for the development of LARS. Anastomotic level has also been proposed as a possible risk factor;...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02166-5 |
| _version_ | 1797454092720668672 |
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| author | Mohammad Reza Hashempour Muhammadhosein Moradi Reza Ghasemian oroomi Siamak Daneshvar Alipasha Meysamie Mohammadreza Nikshoar Fakhrosadat Anaraki |
| author_facet | Mohammad Reza Hashempour Muhammadhosein Moradi Reza Ghasemian oroomi Siamak Daneshvar Alipasha Meysamie Mohammadreza Nikshoar Fakhrosadat Anaraki |
| author_sort | Mohammad Reza Hashempour |
| collection | DOAJ |
| description | Abstract Background The etiology of LARS has not been elaborated on clearly. Studies have reported neoadjuvant therapy, low-lying rectal cancers, adjuvant therapy and anastomotic leakage as risk factors for the development of LARS. Anastomotic level has also been proposed as a possible risk factor; However, there have been conflicting results. This study aims to evaluate the role of the level of anastomosis as a potential risk factor for the development of LARS. Method A systematic literature search was conducted on Pubmed, Scopus, Embase, and Web of Science databases using Mesh terms and non-Mesh terms from 2012 to 2023. Original English studies conducted on rectal cancer patients reporting of anastomotic level and LARS status were included in this study. Eligible studies were assessed regarding quality control with Joanna-Briggs Institute (JBI) questionnaires. Results A total of 396 articles were found using the research queries, and after applying selection criteria 4 articles were selected. A sample population of 808 patients were included in this study with a mean age of 61.51 years with male patients consisting 59.28% of the cases. The Mean assessment time was 15.6 months which revealed a mean prevalence of 48.89% for LAR syndrome. Regression analysis revealed significantly increased risk of LAR syndrome development due to low anastomosis level in all 4 studies with odds ratios of 5.336 (95% CI:3.197–8.907), 3.76 (95% CI: 1.34–10.61), 1.145 (95% CI: 1.141–2.149) and 2.11 (95% CI: 1.05–4.27) for low anastomoses and 4.34 (95% CI: 1.05–18.04) for ultralow anastomoses. Conclusions LARS is a long-term complication following surgery, leading to reduced quality of life. Low anastomosis level has been reported as a possible risk factor. All of the studies in this systematic review were associated with an increased risk of LARS development among patients with low anastomosis. |
| first_indexed | 2024-03-09T15:32:15Z |
| format | Article |
| id | doaj.art-85204964e54642f299c87d0a9acf7d7f |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-09T15:32:15Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-85204964e54642f299c87d0a9acf7d7f2023-11-26T12:11:46ZengBMCBMC Surgery1471-24822023-09-012311710.1186/s12893-023-02166-5Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review studyMohammad Reza Hashempour0Muhammadhosein Moradi1Reza Ghasemian oroomi2Siamak Daneshvar3Alipasha Meysamie4Mohammadreza Nikshoar5Fakhrosadat Anaraki6Colorectal Division of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical SciencesSchool of Medicine, Shahid Beheshti University of Medical SciencesColorectal Division of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical SciencesColorectal Division of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical SciencesCommunity and Preventive Medicine Department, Medical Faculty, Tehran University of Medical SciencesColorectal Division of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical SciencesColorectal Division of Surgical Ward, Taleghani Hospital, Shahid Beheshti University of Medical SciencesAbstract Background The etiology of LARS has not been elaborated on clearly. Studies have reported neoadjuvant therapy, low-lying rectal cancers, adjuvant therapy and anastomotic leakage as risk factors for the development of LARS. Anastomotic level has also been proposed as a possible risk factor; However, there have been conflicting results. This study aims to evaluate the role of the level of anastomosis as a potential risk factor for the development of LARS. Method A systematic literature search was conducted on Pubmed, Scopus, Embase, and Web of Science databases using Mesh terms and non-Mesh terms from 2012 to 2023. Original English studies conducted on rectal cancer patients reporting of anastomotic level and LARS status were included in this study. Eligible studies were assessed regarding quality control with Joanna-Briggs Institute (JBI) questionnaires. Results A total of 396 articles were found using the research queries, and after applying selection criteria 4 articles were selected. A sample population of 808 patients were included in this study with a mean age of 61.51 years with male patients consisting 59.28% of the cases. The Mean assessment time was 15.6 months which revealed a mean prevalence of 48.89% for LAR syndrome. Regression analysis revealed significantly increased risk of LAR syndrome development due to low anastomosis level in all 4 studies with odds ratios of 5.336 (95% CI:3.197–8.907), 3.76 (95% CI: 1.34–10.61), 1.145 (95% CI: 1.141–2.149) and 2.11 (95% CI: 1.05–4.27) for low anastomoses and 4.34 (95% CI: 1.05–18.04) for ultralow anastomoses. Conclusions LARS is a long-term complication following surgery, leading to reduced quality of life. Low anastomosis level has been reported as a possible risk factor. All of the studies in this systematic review were associated with an increased risk of LARS development among patients with low anastomosis.https://doi.org/10.1186/s12893-023-02166-5Low anterior resection syndromeRectal neoplasmsAnastomosisPostoperative complications |
| spellingShingle | Mohammad Reza Hashempour Muhammadhosein Moradi Reza Ghasemian oroomi Siamak Daneshvar Alipasha Meysamie Mohammadreza Nikshoar Fakhrosadat Anaraki Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study BMC Surgery Low anterior resection syndrome Rectal neoplasms Anastomosis Postoperative complications |
| title | Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study |
| title_full | Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study |
| title_fullStr | Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study |
| title_full_unstemmed | Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study |
| title_short | Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study |
| title_sort | assessing the role of anastomotic level in low anterior resection lar surgery among rectal cancer patients in the development of lar syndrome a systematic review study |
| topic | Low anterior resection syndrome Rectal neoplasms Anastomosis Postoperative complications |
| url | https://doi.org/10.1186/s12893-023-02166-5 |
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