Clinical Utility and Characteristics of the LARS Score Compared to the CCIS
Clinical Utility and Characteristics of the LARS Score Compared to the CCIS
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DOI：
10.1007/s00268-021-06405-9
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发表时间：
2022-02-04
影响因子：
2.6
通讯作者：
Takemasa, Ichiro
中科院分区：
文献类型：
--
作者：
Akizuki, Emi;Okita, Kenji;Takemasa, Ichiro
目的
低位前切除综合征（LARS）评分（LS）已得到广泛验证，并已成为评估术后肠道功能障碍的国际工具。然而，许多医生在LARS治疗中仍使用传统的失禁评分。此外，对LS的解读及其与传统失禁评分的关系尚未得到很好的理解。在此我们将LS与克利夫兰诊所失禁评分（CCIS）进行比较，以阐明LARS评分的临床应用和特点。
方法
我们进行了一项多中心观察性研究，招募了246名接受保肛手术后的直肠癌患者。患者完成了LS、CCIS和SF36问卷。
结果
回复率为76.4%，共对180名患者进行了分析。LS与CCIS密切相关（P < 0.001，rs = 0.727）。然而，在116名被判定无失禁（CCIS 0 - 5）的患者中，有51名（44%）被诊断为LARS（29名轻度LARS，22名重度LARS）。在68名无LARS的患者中，只有3名被诊断为失禁（CCIS > 6）。与背景因素相比，年龄和术后时间仅与LS相关。通过SF - 36评估，高LS和高CCIS均显示出生活质量的显著下降。
结论
这是第一项确定CCIS和LS数值差异的研究。LS可作为LARS筛查的便捷工具，能识别出广泛的LARS患者，包括那些经CCIS评估有失禁的患者。使用CCIS评估可能经常低估LARS。
Purpose The low anterior resection syndrome (LARS) score (LS) has been widely validated and has become an international tool for evaluating postoperative bowel dysfunction. However, many physicians still use the conventional incontinence scores in LARS treatment. Moreover, interpretation of LS and its relationship with conventional incontinence scores are not yet well understood. Here we compared the LS with the Cleveland Clinic Incontinence Score (CCIS) to clarify the clinical utility and characteristics of the LARS score. Methods We performed a multicentre observational study, recruiting 246 rectal cancer patients following sphincter-preserving surgery. Patients completed the LS, CCIS, and SF36 questionnaires. Results The response rate was 76.4%, and a total of 180 patients were analysed. The LS was strongly correlated with the CCIS (P < 0.001, rs = 0.727). However, among 116 patients determined to not have incontinence (CCIS 0-5), 51 (44%) were diagnosed with LARS (29 with minor LARS and 22 with major LARS). Among 68 patients without LARS, only 3 were diagnosed as having incontinence (CCIS > 6). In comparison with background factors, aging and elapsed time were associated with only LS. High LS and CCIS both showed significant quality-of-life impairment as assessed by the SF-36. Conclusion This is the first study to determine the difference in the numeric values between the CCIS and LS. The LS can be a convenient tool for LARS screening, identifying a wide range of patients with LARS, including those with incontinence evaluated by CCIS. Assessment using the CCIS may often underestimate LARS.