Das Low anterior Resection Syndrome (LARS): Diagnostik – Therapie – Prophylaxe

BACKGROUND: As 5-year survival after rectal cancer surgery has reached 80%, there is increasing interest in quality of life. Low anterior resection syndrome (LARS) is an overall measure of the postoperative functional disorder due to the surgical resection. MATERIAL UND METHODE: Es wurde eine selektive Literaturrecherche durchgefuhrt, um das Bild des LARS naher zu definieren und Verstandnis fur seine Pathophysiologie, Diagnose, Therapie und Prophylaxe zu entwickeln. RESULTS: LARS is observed after up to 80% of stoma sparing procedures performed for rectal carcinoma. The capacity of the rectal remnant as well as intraoperative damage to neuronal structures seem to be the most important pathogenetic factors resulting in a substantial impairment of the quality of life. Pelvic floor rehabilitation, rectal balloon distension training, biofeedback, anal irrigation, and sacral nerve stimulation are multimodal treatment options for LARS. CONCLUSIONS: Various therapeutic approaches exist to attenuate the consequences of LARS for the individual patient. Nevertheless, considerable work has to be done in the future not only to improve survival but also the quality of live after rectal carcinoma.