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Purpose <p>To report the quality of life (QoL) and functional outcomes in patients with colorectal disease after receiving treatment in a multidisciplinary, nurse-led low anterior resection syndrome (LARS) outpatient clinic post surgery.</p> Methods <p>A retrospective observational study was conducted that included all patients with colorectal disease referred to the LARS outpatient clinic at VieCuri Medical Centre between January 2021 and December 2024. A standardized treatment protocol was implemented, complemented by a nurse-led component that enabled early symptom detection and provided accessible, intensive patient contact and follow-up. The structured five-phase protocol ranges from preoperative counseling and conservative management to multidisciplinary care and, if necessary, invasive interventions. Bowel function and quality of life were assessed pre- and post-treatment using validated instruments, including the LARS score, Wexner score, and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-C29 questionnaires.</p> Results <p>A total of 96 patients were included. Median LARS scores decreased from 38.0 to 13.0 (<i>p</i> &lt; 0.001), with 76% of patients transitioning from major to no LARS. Wexner scores improved from 11.0 to 2.0 (<i>p</i> &lt; 0.001), and global QoL increased from 66.7 to 83.3 (<i>p</i> &lt; 0.001). Pharmacological treatment was administered to 93% of patients, most commonly psyllium and loperamide. In addition, 85% were referred to a dietitian, 50% to pelvic floor physiotherapy, and 26% to a psychologist or sexologist. Transanal irrigation was introduced in 14% of cases. Only one patient required sacral neuromodulation, and one opted for a permanent stoma. The median follow-up consisted of three in-person and three telephone consultations per patient.</p> Conclusions <p>A multidisciplinary, nurse-led LARS clinic significantly improved bowel function and QoL in patients with colorectal cancer (CRC). These findings support the implementation of structured, individualized care pathways for LARS management.</p>

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The first Dutch experience with a nurse-led outpatient clinic for the prevention and treatment of LARS after colorectal surgery: promising results of a standardized treatment protocol

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • C. Smit,
  • M. L. Janssen-Heijnen,
  • F. van Osch,
  • M. van Heinsbergen,
  • J. L. M. Konsten

摘要

Purpose

To report the quality of life (QoL) and functional outcomes in patients with colorectal disease after receiving treatment in a multidisciplinary, nurse-led low anterior resection syndrome (LARS) outpatient clinic post surgery.

Methods

A retrospective observational study was conducted that included all patients with colorectal disease referred to the LARS outpatient clinic at VieCuri Medical Centre between January 2021 and December 2024. A standardized treatment protocol was implemented, complemented by a nurse-led component that enabled early symptom detection and provided accessible, intensive patient contact and follow-up. The structured five-phase protocol ranges from preoperative counseling and conservative management to multidisciplinary care and, if necessary, invasive interventions. Bowel function and quality of life were assessed pre- and post-treatment using validated instruments, including the LARS score, Wexner score, and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-C29 questionnaires.

Results

A total of 96 patients were included. Median LARS scores decreased from 38.0 to 13.0 (p < 0.001), with 76% of patients transitioning from major to no LARS. Wexner scores improved from 11.0 to 2.0 (p < 0.001), and global QoL increased from 66.7 to 83.3 (p < 0.001). Pharmacological treatment was administered to 93% of patients, most commonly psyllium and loperamide. In addition, 85% were referred to a dietitian, 50% to pelvic floor physiotherapy, and 26% to a psychologist or sexologist. Transanal irrigation was introduced in 14% of cases. Only one patient required sacral neuromodulation, and one opted for a permanent stoma. The median follow-up consisted of three in-person and three telephone consultations per patient.

Conclusions

A multidisciplinary, nurse-led LARS clinic significantly improved bowel function and QoL in patients with colorectal cancer (CRC). These findings support the implementation of structured, individualized care pathways for LARS management.