International Consensus Definition of Low Anterior Resection Syndrome
Keane, Celia (University of Auckland)
Fearnhead, Nicola S. (Cambridge University Hospitals NHS Foundation Trust (Regne Unit))
Bordeianou, Liliana G. (Harvard Medical School)
Christensen, Peter (Aarhus University Hospital (Aarhus, Dinamarca))
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron)
Laurberg, Søren (Aarhus University Hospital (Aarhus, Dinamarca))
Mellgren, Anders (University of Illinois at Chicago)
Messick, Craig (The University of Texas MD Anderson Cancer Center)
Orangio, Guy R. (Louisiana State University)
Verjee, Azmina (Bowel Disease Research Foundation)
Wing, Kirsty (Otago Community Hospice)
Bissett, Ian (Auckland City Hospital)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Supplemental Digital Content is available in the text. The aim of this collaboration was to develop an international consensus definition of low anterior resection syndrome that encompasses all aspects of the condition and is informed by all stakeholders. This international patient-provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons, and other health professionals from 5 regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in 3 languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of low anterior resection syndrome. Three hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96%, and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to 8 symptoms and 8 consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. This is the first definition of low anterior resection syndrome developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of low anterior resection syndrome. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in low anterior resection syndrome over time and with intervention.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Consensus definition ; Low anterior resection syndrome ; Patient reported ; Rectal resection
Published in:	Diseases of the Colon and Rectum, Vol. 63 (february 2020) , p. 274-284, ISSN 1530-0358

DOI: 10.1097/DCR.0000000000001583
DOI: 10.1111/codi.14957
PMID: 32032141

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