Distinct trajectories of low anterior resection syndrome following ileostomy reversal.

Authors

Xuena Zhang, Qingyu Meng, Jingru Wang, Simeng Jiang, Zhongtao Tian, Zihan Fan, Tong Wang, Wenbo Niu

Published in

Frontiers in medicine. Volume 13. Pages 1735910. Epub Jun 30, 2026.

Abstract

This study is an midterm postoperative assessment of LARS symptoms, aiming to apply group-based trajectory modeling to analyze the symptom trajectories of low anterior resection syndrome in rectal cancer patients who underwent ileostomy and subsequent reversal, and to investigate the clinical and treatment-related factors influencing these trajectories.
A retrospective cohort of 134 rectal cancer patients who underwent low anterior resection with diverting ileostomy and subsequent reversal was analyzed. LARS scores were recorded at 3, 6, 9, and 12 months postoperatively. GBTM was used to classify patients into symptom trajectory groups. Multinomial logistic regression identified clinical factors associated with each trajectory.
Among 134 rectal cancer patients included, group-based trajectory modeling identified three LARS symptom trajectories following stoma reversal: mild and recovering (30.6%), moderate and fluctuating (40.3%), and severe and persistent (29.1%). Over the 12-months follow-up, LARS scores declined overall, with significant differences in symptom severity observed among the three groups at all time points (P < 0.001). Most patients in the mild trajectory group improved steadily and had no LARS by 12 months, whereas nearly half of the patients in the severe trajectory group continued to experience major LARS. Multivariable analysis revealed that higher T stage, lower anastomotic height, and receipt of preoperative radiotherapy were independently associated with worse trajectories.
Preoperative radiotherapy, low anastomotic height, and advanced tumor stage significantly increase the probability of following a severe and persistent LARS trajectory. Recognizing these factors as probabilistic risks rather than absolute determinants may facilitate early tailored interventions and enhance personalized postoperative recovery.

PMID:
42454113
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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