低位前切除综合征诊治中国专家共识(2025版)
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中国医师协会肛肠医师分会

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国家自然科学基金资助项目(82172845)。


Chinese expert consensus on the diagnosis and treatment of low anterior resection syndrome (2025 Edition)
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    摘要:

    低位前切除综合征(LARS)是直肠癌患者保肛术后常见的肠道功能障碍症候群,以储便与排空功能障碍为特征,已成为影响患者术后生活质量与临床结局的重要因素。目前对于LARS的致病机制尚不完全明确,仍缺少高质量循证依据指导临床实践。通过制定合理的肿瘤治疗方案、选择适宜的手术方式、评估真实的多维度症状特征、应用有效的预防干预策略以及实施规范的全程管理,能够有效减轻LARS症状的严重程度,进而改善患者生活质量。鉴于国内各级临床医师在LARS诊治过程中缺乏指导性共识意见,中国医师协会肛肠医师分会组织国内相关领域专家,检索并复习国内外研究成果,借鉴国外经验和指南,并结合国内实际情况,制定了《低位前切除综合征诊治中国专家共识(2025版)》。该共识从LARS的定义、临床表现、危险因素、病理生理机制、症状评估、治疗方法和预防策略等方面进行阐述,以期促进我国直肠癌患者保肛术后LARS的规范化诊治。

    Abstract:

    Low anterior resection syndrome (LARS) is a common bowel dysfunction syndrome following sphincter-preserving surgery for rectal cancer, characterized by stool storage dysfunction and evacuatory dysfunction. It has become a critical factor adversely affecting patients"" quality of life and long-term clinical outcomes. Currently, the pathogenic mechanisms of LARS remain incompletely elucidated, and high-quality evidence to guide clinical practice is still lacking. However, emerging evidence suggests that strategic optimization across the clinical management pathway—including precision oncology planning, surgical technique selection, multidimensional symptom profiling, proactive prevention protocols, and comprehensive symptom management—may effectively reduce LARS severity and improve survivorship outcomes. Given the absence of consensus guidelines for LARS management among clinicians across China, the Chinese Society of Coloproctology (Chinese Medical Doctor Association) organized domestic experts in relevant fields. Through systematic review of global research findings, integration of international expertise and guidelines, and adaptation to domestic clinical realities, we developed the Chinese expert consensus on the diagnosis and treatment of low anterior resection syndrome (2025 edition). This consensus elaborates on key aspects including the definition, clinical manifestations, risk factors, pathophysiological mechanisms, symptom assessment, treatment modalities, and prevention strategies for LARS, aiming to standardize the diagnosis and management of LARS in China.

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中国医师协会肛肠医师分会.低位前切除综合征诊治中国专家共识(2025版)[J].中国普通外科杂志,,().
DOI:10.7659/j. issn.1005-6947.250357

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  • 收稿日期:2025-07-01
  • 最后修改日期:2025-07-01
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  • 在线发布日期: 2025-07-23