Colorectal nursing and low anterior resection syndrome

The author has worked for many years as a biofeedback nurse in secondary care settings providing care for patients with low anterior resection syndrome (LARS). The aim of this article is to present some of the most recent evidence-based information in conjunction with experiential observations from clinical practice.

In 1948, the results of the restorative anterior resection for rectal cancer and avoidance of a permanent stoma were published (Dixon, 1948). The anterior resection procedure is now a common operation for rectal cancers, often combined with a total mesenteric exenteration (TME) for mid or low rectal cancers. TME involves the careful removal of the tissue surrounding the rectum up to the levators, thereby reducing the risk of local cancer recurrence (Taylor and Bradshaw, 2013). Patients have a temporary ileostomy to allow healing, and then undergo restoration of continuity (stoma reversal).

LARS was originally described as the symptoms occurring after temporary stoma reversal, or ‘bowel dysfunction following low rectal resection’ (Keane et al, 2020). In 2020 the first consensus definition was formulated following a large Delphi study with patient and clinician engagement (Keane et al, 2020).