{"title":"Impact of low anterior resection syndrome after rectal surgery on sleep quality.","authors":"Akira Toyoshima, Toshihiro Nishizawa, Osamu Toyoshima, Ryuji Akai, Manabu Kaneko, Shin Sasaki","doi":"10.1007/s00595-025-03092-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The factors contributing to the association between rectal cancer and sleep impairment remain unclear. We investigated the risk factors for sleep impairment after anus-preserving surgery for rectal cancer.</p><p><strong>Methods: </strong>This cross-sectional study investigated surviving patients who underwent low anterior or intersphincteric resection with curative intent for rectal cancer located < 15 cm from the anal verge. Defecatory dysfunction and sleep quality were assessed using the low anterior resection syndrome (LARS) score and the Pittsburgh Sleep Quality Index, respectively.</p><p><strong>Results: </strong>A total of 176 patients were included in this analysis. The sleep impairment rate in the \"major LARS\" group was significantly higher than that in the \"no/minor LARS\" group (54.5 vs. 24.2%; p < 0.001). Multivariable analysis identified that age (odds ratio = 0.943) and tumor height (odds ratio = 0.893) were independently associated with major LARS. In the multivariable analysis for sleep impairment, major LARS (odds ratio = 4.490, p < 0.001) and adjuvant (pre/post) chemotherapy (odds ratio = 3.400, p = 0.003) were independently associated with sleep impairment.</p><p><strong>Conclusion: </strong>Sleep quality was reduced significantly in patients with major LARS after rectal cancer surgery. Adjuvant chemotherapy also impairs sleep quality, while low tumor location and young age were independent risk factors for major LARS.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03092-0","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The factors contributing to the association between rectal cancer and sleep impairment remain unclear. We investigated the risk factors for sleep impairment after anus-preserving surgery for rectal cancer.
Methods: This cross-sectional study investigated surviving patients who underwent low anterior or intersphincteric resection with curative intent for rectal cancer located < 15 cm from the anal verge. Defecatory dysfunction and sleep quality were assessed using the low anterior resection syndrome (LARS) score and the Pittsburgh Sleep Quality Index, respectively.
Results: A total of 176 patients were included in this analysis. The sleep impairment rate in the "major LARS" group was significantly higher than that in the "no/minor LARS" group (54.5 vs. 24.2%; p < 0.001). Multivariable analysis identified that age (odds ratio = 0.943) and tumor height (odds ratio = 0.893) were independently associated with major LARS. In the multivariable analysis for sleep impairment, major LARS (odds ratio = 4.490, p < 0.001) and adjuvant (pre/post) chemotherapy (odds ratio = 3.400, p = 0.003) were independently associated with sleep impairment.
Conclusion: Sleep quality was reduced significantly in patients with major LARS after rectal cancer surgery. Adjuvant chemotherapy also impairs sleep quality, while low tumor location and young age were independent risk factors for major LARS.
目的:直肠癌与睡眠障碍之间的相关因素尚不清楚。我们调查了直肠癌保肛手术后睡眠障碍的危险因素。方法:本横断面研究调查了为治愈目的而行低位前切除术或括约肌间切除术的直肠癌存活患者。结果:共有176例患者纳入本分析。“严重LARS”组的睡眠障碍率显著高于“无/轻微LARS”组(54.5 vs 24.2%;结论:直肠癌术后重度LARS患者睡眠质量明显下降。辅助化疗也会影响睡眠质量,而低肿瘤位置和年轻是主要LARS的独立危险因素。
期刊介绍:
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.