[Anorectal functional disorders following organ-preserving treatment and resection of rectal cancer].

Anorectal functional disorders following curative treatment for rectal cancer range from fecal incontinence to obstructed defecation and represent a symptom complex with tremendous impact on the quality of life in up to 70% of patients. Following resection, symptoms are defined as low anterior resection syndrome (LARS) and can be differentiated into minor LARS and major LARS. Independent factors predictive of LARS include total mesorectal excision, level of the anastomosis and neoadjuvant chemoradiotherapy. Therapeutic options include conservative management (dietary modification, stool regulation), pelvic floor rehabilitation and transanal irrigation. Sacral neuromodulation has been shown to be effective for major LARS. In general, multidisciplinary teams providing professional management according to patient-reported outcome measurements are mandatory. Based on the prevalence of anorectal functional disorders after resection and organ preservation, the description of symptoms restricted to LARS no longer seems appropriate and a new consensus-based definition should be developed.