Abstract:

Objective To establish an expert consensus on the management of low anterior resection syndrome （LARS） in patients with rectal cancer post-surgery（hereinafter referred to as “consensus”），aiming to standardize the related work of medical institutions in the context of post-operative LARS. Methods A comprehensive search of domestic and international databases was conducted to collect guidelines，expert consensuses，systematic reviews，evidence summaries，and original research related to post-operative LARS in rectal cancer published from the establishment of the databases until August 2024. Based on clinical practice experience，a preliminary draft of the “consensus” was formed. From September to November 2024，22 experts were invited to participate in 2 rounds of expert consultations，during which the draft content was revised and improved，and the final version of the “consensus” was determined through expert validation. Results A total of 22 experts responded，achieving a response rate of 100%. The effective recovery rate of the consultation questionnaires in both rounds was 100%，with an expert authority coefficient of 0.89，a judgment coefficient of 0.97，and a familiarity degree of 0.84. The Kendall harmony coefficients for the 2 rounds of expert consultations were 0.122 and 0.136，respectively（P<0.001）. This consensus covers 5 main aspects：definition，assessment，prevention，treatment，and follow-up management of LARS. Conclusion This consensus demonstrates a high level of scientific rigor and can provide a strong reference for clinical nursing personnel in the specialized care of rectal cancer patients with post-operative LARS.

Key words: Rectal Cancer, Low Anterior Resection Syndrome, Management, Expert Consensus, Nursing Care

摘要：

目的 编写直肠癌术后患者低位前切除综合征（low anterior resection syndrome，LARS）管理的专家共识（以下简称“共识”），旨在为规范直肠癌术后患者LARS管理工作提供借鉴。方法 全面检索国内外数据库，检索时限为建库至2024年8月，纳入直肠癌术后患者LARS管理的相关指南、专家共识、系统评价、证据总结及原始研究等文献。基于相关文献和临床实践经验，初步形成了“共识”初稿。2024年9月—11月，邀请22名专家进行2轮专家函询，对“共识”初稿进行了修订和完善，并进行专家论证，形成“共识”终稿。结果 2轮函询问卷的有效回收率均为100%，专家权威系数均为0.89，判断系数均为0.97，熟悉程度均为0.84。2轮专家函询的肯德尔和谐系数分别为0.122和0.136（P<0.001）。该“共识”涵盖了LARS的定义、评估、预防、治疗、随访管理5个方面。结论 该“共识”的构建过程较为科学，能够为临床护士开展直肠癌术后患者LARS护理提供参考。

关键词: 直肠癌, 低位前切除综合征, 管理, 专家共识, 护理