title: Clinical application of the LARS score: results from a pilot study.
abstract: OBJECTIVE
  The impact of the low anterior resection syndrome (LARS) on quality of life has underscored the importance of measuring functional outcomes after treatment for rectal cancer. The aim of this study was to evaluate whether the LARS score as a single questionnaire was useful enough in the clinical setting.
  
  
  METHODS
  Patients treated by curative anterior resection for rectal cancer were sent the LARS score and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 questionnaires by post. Patients classified as "minor" and "major" LARS according to the LARS score were visited. Assessment included several scores (Vaizey score, Altomare Obstructed Defecation Syndrome score, Bristol scale). Patients with urgency/faecal incontinence also filled in a bowel diary and the FIQL score.
  
  
  RESULTS
  Seventy patients returned the questionnaires, 49 of whom ("major LARS" and "minor LARS") were visited and 19 ("no LARS") were assessed by phone. Four different clinical patterns were identified. The group with urgency/faecal incontinence was the largest (33.8 %), whereas 17.7 % referred evacuatory dysfunction. The LARS score did not correctly evaluate 18 patients: 5 who were classified as no LARS but had severe evacuatory dysfunction and 13 patients categorized as LARS but without significant bowel dysfunction, 9 of whom were classified as major LARS.
  
  
  CONCLUSIONS
  The LARS score may overestimate the impact on quality of life in some patients and may underestimate the impact of severe evacuatory dysfunction. Due to the complexity of the LARS, the LARS score as a single questionnaire might not be enough to assess bowel function. A complete clinical evaluation and additional questionnaires might be required.
authors: Department of Surgery, Consorci Sanitari de Terrassa, Ctra. de Torrebonica s/n, 080227, Terrassa, Barcelona, Spain. yribas@cst.cat.
authors: Yolanda
authors: http://orcid.org/0000-0002-9254-2864
authors: Y
authors: Ribas
authors: Department of Surgery, Consorci Sanitari de Terrassa, Ctra. de Torrebonica s/n, 080227, Terrassa, Barcelona, Spain.
authors: Francesc
authors: F
authors: Aguilar
authors: Department of Epidemiology, Consorci Sanitari de Terrassa, Terrassa, Spain.
authors: Esther
authors: E
authors: Jovell-Fernández
authors: Department of Surgery, Consorci Sanitari de Terrassa, Ctra. de Torrebonica s/n, 080227, Terrassa, Barcelona, Spain.
authors: Ladislao
authors: L
authors: Cayetano
authors: Department of Surgery, Hospital Universitari Mútua Terrassa, Terrassa, Spain.
authors: Albert
authors: A
authors: Navarro-Luna
authors: Department of Surgery, Hospital Universitari Mútua Terrassa, Terrassa, Spain.
authors: Arantxa
authors: A
authors: Muñoz-Duyos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D005243:Feces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012004:Rectal Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D013577:Syndrome
keywords: Evacuatory dysfunction; Faecal incontinence; LARS score; Low anterior resection syndrome; Rectal cancer