![]() Recently, a large international consensus trilingual Delphi process with patients as the major stakeholder refined the definition of LARS. Named after the surgical procedure commonly responsible for this clinical picture, LARS shows a high prevalence (60%–90%) and can last for years after surgical treatment. This wide range of complaints has been collated into a pragmatic definition, i.e. ![]() The spectrum of such dysfunction is broad, and can include incontinence, constipation and clustering of stool, all of which have a negative impact on health-related quality of life (HRQoL). In the past, evidence suggested that a colostomy might be associated with worse quality of life compared with anal continence, but bowel dysfunction is common after anatomical preservation of the sphincters. INTRODUCTIONīowel function is significantly affected after rectal surgery. This manuscript represents a practical and balanced guide which will help clinicians and patients navigate the literature and choose the ideal treatment and associated consequences. Low anterior resection syndrome has a severe impact on quality of life. What does this paper add to the literature? The MANUEL project provides an up-to-date practical summary of the available evidence concerning LARS, with useful directions for healthcare professional and patients suffering from this debilitating condition. Given the lack of sound evidence and the often poor quality of the studies, most of the recommendations and conclusions are based on the opinions of the experts. The guidance covers all aspects of LARS management, from pathophysiology, to assessment and management. A final teleconference was held at the end of the project. The manuscript was again circulated and finalized. A lay patient revised the manuscript, and contributed to a section containing a patient's perspective. This was circulated among the collaborators, and it was revised following the comments received. Each working group generated a draft these were collated by another collaborator into a manuscript, after a conference call. Eight themes were decided upon and working groups established. After a face-to-face meeting, a strategy was agreed to create a comprehensive, practical guide covering all aspects that were felt to be clinically relevant. The ‘Management guidelines for low anterior resection syndrome’ (MANUEL) project was promoted by a team of eight experts in the assessment and management of patients with LARS. The aim of the LARS Expert Advisory Panel was to develop practical guidance for healthcare professionals dealing with LARS. This searches for items where "Journal of the American College of Cardiology" is listed as the source.Little is known about the pathophysiology of low anterior resection syndrome (LARS), and evidence concerning the management of patients diagnosed with this condition is scarce. "Journal of the American College of Cardiology" This searches for items where the word 'heart' exists in all of the headline, description and tags fields.Įg3. This searches for the phrase 'kidney cancer' in the title as well as either the word 'trial' or 'trials' in description. search on a specific field using any of the following: "kidney cancer" (trial |trials).Here the word 'chronic' must come somewhere before either the work 'leukemia' or 'leukaemia'. order operator: word1 Will return records where either the words 'cancer' or 'cancers' are present, plus the words 'cervical' or 'cervix', but not the phrase 'squamous cell carcinoma' or 'SCC'. AND is implied so listing two words without another operator will search for records where both words are present.Įg.(cancer |cancers)(cervical |cervix)!("Squamous cell carcinoma"|SCC). Advanced search can include the following:
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