SP9.01 A Systematic Review of Comparative Effectiveness of Interventions for Low Anterior Resection Syndrome: Impacts on Bowel Function and Quality of Life

Abstract Aims Low anterior resection syndrome (LARS) is a debilitating complication following sphincter-preserving surgery for rectal cancer. This systematic review aimed to evaluate effectiveness of invasive and non-invasive interventions for LARS, including pelvic floor rehabilitation, transanal irrigation, and surgical options such as sacral neuromodulation and stoma formation, on bowel function and quality of life. Methods A structured search was performed in PubMed/MEDLINE database, Cochrane Collaboration Library, and Google Scholar for studies which were published in the last decade involving adult patients diagnosed with LARS post-low anterior resection (LAR). Eligibility criteria focused on interventions assessed through bowel function and quality of life metrics. Six studies, comprising 794 patients with sample sizes ranging from 37 to 430 participants, were included in final analysis. Results Pelvic floor rehabilitation demonstrated significant improvement in bowel function and quality of life in LARS patients, particularly in motivated individuals. However, the variability in patient responses underscored the complexity of managing LARS. Surgical interventions, including sacral neuromodulation and stoma formation, were generally reserved for severe cases but carried substantial risks and psychological impacts. Despite promising results with non-invasive interventions, long-term sustainability and optimal management strategies remain unclear. Conclusion LARS management requires a multifaceted, individualized approach tailored to patient needs and risk profiles. Early identification of patients at high risk for LARS and incorporation of treatment discussions during initial care planning are crucial. Future research should prioritize comparing treatment modalities, assessing cost-effectiveness, and exploring their impact on patients' quality of life and mental health to address existing evidence gaps.