Background: Low anterior resection syndrome (LARS) is a term that encompasses multidimensional bowel dysfunction that typically occurs following resections of rectum and distal parts of the colon. We aimed to systematically assess the available literature on the effects of bowel dysfunction after colorectal cancer (CRC) surgeries on health-related quality of life (HRQOL) and conduct a meta-analysis.

Methods: Studies were included if they assessed patients who had undergone sphincter-preservation surgeries for CRC. Studies were eligible if they assessed bowel dysfunction using the LARS score and HRQOL using the European Organization for Research and Treatment Core Quality-of-Life Questionnaire (EORTC QLQ-C30).

Results: Of 1410 reports, 28 studies were included. According to the analyses, patients with major LARS had lower global health status [weighted mean differences (WMD) = - 10.98; 95% confidence interval (CI) - 13.18, - 8.79], physical functioning (WMD = - 5.96; 95% CI - 7.40, - 4.52), role functioning (WMD = - 10.59; 95% CI - 12.54, - 8.63), emotional functioning (WMD = - 11.09; 95% CI - 14.34, 7.84), cognitive functioning (WMD = - 9.27; 95% CI - 12.22, - 6.32), and social functioning (WMD = - 15.73; 95% CI - 18.82, - 12.63) and higher scores of symptoms compared to patients with minor/no LARS.

Conclusions: The study findings suggest that patients with major LARS experience worse HRQOL compared to those with minor/no LARS.

Registration: PROSPERO, CRD42023479657.

Keywords: Colorectal neoplasms; Low anterior resection syndrome; Meta-analysis; Quality of life; Systematic review.

© 2025. The Author(s).

背景：低前切除综合症（LARS）是一组多维度的肠道功能障碍，通常发生在直肠和降结肠远端部分切除手术后。我们旨在系统地评估结直肠癌（CRC）手术后的肠道功能障碍对健康相关生活质量（HRQOL）的影响，并进行元分析。

方法：如果研究评估了接受保留括约肌的CRC手术的患者，则被纳入其中。这些研究需要使用LARS评分评估肠道功能障碍，并且使用欧洲肿瘤组织核心生命质量问卷（EORTC QLQ-C30）来评估健康相关生活质量。

结果：在1410份报告中，有28项研究被纳入。根据分析结果显示，患有严重LARS的患者整体健康状况较差[加权平均差值(WMD) = - 10.98；95%置信区间(CI) - 13.18, - 8.79]，身体功能(WMD = - 5.96；95% CI - 7.40, - 4.52)，角色功能(WMD = - 10.59；95% CI - 12.54, - 8.63)，情感功能(WMD = - 11.09；95% CI - 14.34, 7.84)，认知功能(WMD = - 9.27；95% CI - 12.22, - 6.32)和社交功能(WMD = - 15.73；95% CI - 18.82, - 12.63)，并且症状评分高于轻度/无LARS的患者。

结论：研究表明，患有严重LARS的患者的健康相关生活质量比轻度/无LARS的患者更差。

注册信息：PROSPERO, CRD42023479657.

关键词：结直肠肿瘤；低前切除综合症；元分析；生活质量；系统综述。

© 2025. 作者保留所有权利。