Watford LARS pathway

Watford LARS pathway

Approximately 8,680 patients have an anterior resection each year for bowel cancer, with 6,600 receiving a stoma (National Cancer Strategy, 2018).  
 
Advancements in colorectal surgery have seen the use of sphincter-preserving rectal surgery with a low colorectal or colo-anal anastomosis (Berger etal, 2016), involving a temporary ileostomy, which is considered standard practice for most colorectal surgeons in the UK (Powell-Chandler et al, 2018).
 
Following reversal of a stoma, there is increasing awareness of the high incidence of bowel dysfunction experienced by patients, defined as low anterior resection syndrome (LARS).
 
Protocols for treatment strategies were somewhat limited until the publication of the ‘Watford LARS pathway’, which outlines strategies in the management of symptoms prior to stoma reversal and post stoma reversal.
 
Well done Deborah Sumner, Senior Nurse Practitioner, West Hertfordshire NHS Trust, in developing a much needed and incredible service/pathway that can only advance patient care in this group of patients. 
 
Brigitte Collins
Global Clinical Education Manager
  • Berger et al (2016) Low anterior resection syndrome: current management and future directions. Clin Colon Rectal Surg, 29(03);239-245
  • National Cancer Strategy (2015) www.england.nhs.uk/cancer/ invest/
  • Power-Chandler et al (2018) PARiS (Physiotherapy and Anterior Resection Syndrome) Trial Management Group. Feasibility study protocol. BMJ Open, 8(6);e021855
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