Long-Term Bowel Dysfunction After Rectal Cancer Surgery

Nearly four in ten rectal cancer survivors still have major low anterior resection syndrome five or more years after sphincter-preserving surgery.

• Across six studies (1,000 patients, follow-up 6.9 to 14.6 years), 39.3% had major low anterior resection syndrome and 21.5% had minor symptoms.
• Major symptoms were consistently linked to worse health-related quality of life across several domains.
• Neoadjuvant radiotherapy was the most consistent risk factor for persistent bowel dysfunction.

Surgeons should counsel rectal cancer patients, especially those given neoadjuvant radiotherapy, that bowel symptoms may last for years, and plan long-term functional follow-up. The pooled data come from observational studies with heterogeneous radiotherapy regimens and tumor heights, so they show how common the problem is, not how to prevent it.