Bryant CLC, Lunniss PJ, Knowles CH, Thaha MA, Chan CLH. Anterior resection syndrome. Lancet Oncol. 2012; 13:(9)e403-e408

Burch J, Taylor C, Wilson A, Norton C. Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: a systematic review. Eur J Oncol Nurs. 2021; 52

Christensen P, Baeten CIM, Espín-Basany E Management guidelines for low anterior resection syndrome—the MANUEL project. Colorectal Dis. 2021; 23:(2)461-475

Dixon CF. Anterior resection for the malignant lesions of the upper part of the rectum and lower part of the sigmoid. Ann Surg. 1948; 128:(3)425-442

Embleton R, Henderson M. Using transanal irrigation in the management of low anterior resection syndrome: a service audit. Br J Nurs. 2021; 30:(21)1226-1230

Emmanuel A, Collins B, Henderson M, Lewis L, Stackhouse K. Development of a decision guide for transanal irrigation in bowel disorders. Gastrointestinal Nursing. 2019; 17:(7)24-30

Keane C, Fearnhead NS, Bordeianou L International consensus definition of low anterior resection syndrome. Dis Colon Rectum. 2020; 63:(3)274-284

Kupsch J, Kuhn M, Matzel K To what extent is low anterior resection syndrome (LARS) associated with quality of life as measured using the EORTC C30 and CR38 quality of life questionnaires?. Int J Colorectal Dis. 2019; 34:(4)747-762

Mekhael M, Kristensen H, Larsen ML Transanal irrigation for neurogenic bowel disease, low anterior resection, faecal incontinence and chronic constipation: a systematic review. J Clin Med. 2021; 10:(4)

Ness W. Managing faecal incontinence. Br J Nurs. 2018; 27:(7)378-381

National Institute for Health and Care Excellence. Colorectal cancer (update): Optimal management of low anterior resection syndrome. Evidence review E2 for NICE guideline NG151. 2020. (accessed 15 February 2020)

National Institute for Health and Care Excellence, Symptoms suggestive of gastrointestinal (lower tract) cancers. Clinical Knowledge Summary. 2021a. (accessed 15 February 2022)

National Institute for Health and Care Excellence. Colorectal cancer. NICE guideline NG151. 2021b. (accessed 15 February 2022)

Pape E, Pattyn P, Van Hecke A Impact of low anterior resection syndrome (LARS) on the quality of life and treatment options of LARS—a cross sectional study. Eur J Oncol Nurs. 2021; 50

Ridolfi TJ, Berger N, Ludwig KA. Low anterior resection syndrome: current management and future directions. Clin Colon Rect Surg. 2016; 29:(3)239-245

Rosen HR, Boedecker C, Fürst A, Krämer G, Hebenstreit J, Kneist W. “Prophylactic” transanal irrigation (TAI) to prevent symptoms of low anterior resection syndrome (LARS) after rectal resection: results at 12-month follow up of a controlled randomized multicenter trial. Tech Coloproctology. 2020; 24:(12)1247-1253

Taylor C, Bradshaw E. Tied to the toilet: lived experiences of altered bowel function (anterior resection syndrome) after temporary stoma reversal. J Wound Ostomy Continence Nurs. 2013; 40:(4)415-421

Visser WS, Te Riele WW, Boerma D, van Ramshorst B, van Westreener HL. Pelvic floor rehabilitation to improve functional outcome after a low anterior resection: a systematic review. Ann Coloproctol. 2014; 30:(3)109-114

Colorectal nursing and low anterior resection syndrome

24 February 2022
6 min read
Volume 31 · Issue 4

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).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content