Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug;42(8):2660-2667.
doi: 10.1007/s00268-018-4519-8.

Validation of the Japanese Version of the Low Anterior Resection Syndrome Score

Emi Akizuki  1 , Hiroshi Matsuno  2 , Tetsuta Satoyoshi  1 , Masayuki Ishii  1 , Akihiro Usui  1 , Tomomi Ueki  1 , Toshihiko Nishidate  1 , Kenji Okita  1 , Tsunekazu Mizushima  2 , Masaki Mori  2 , Ichiro Takemasa  3
Affiliations

Validation of the Japanese Version of the Low Anterior Resection Syndrome Score

Emi Akizuki et al. World J Surg. 2018 Aug.

Abstract

Background: The low anterior resection syndrome (LARS) score is a patient-reported outcome measure to evaluate the severity of bowel dysfunction after rectal cancer surgery by scoring the major symptoms of LARS. The aim of this study was to translate the English version of the LARS score into Japanese and to investigate the validity and reliability of the LARS score.

Methods: The LARS score was translated in Japanese following current international recommendations. A total of 149 rectal cancer patients completed the LARS score questionnaire and were also asked a single question assessing the impact of bowel function on quality of life (QoL). A total of 136 patients answered the LARS score questionnaire twice.

Results: The Japanese LARS score showed high convergent validity, based on its good correlation between the LARS score and QoL (p < 0.001). The LARS score was able to discriminate between patients according to the tumor distance to anal verge (p < 0.001), type of surgery (p < 0.001), and time since surgery (p = 0.001). Patients after ultra-low anterior resection and intersphincteric resection showed especially high scores. The score also had high test-retest reliability (intraclass correlation coefficient: 0.87).

Conclusion: The Japanese LARS score is a valid and reliable tool for measuring LARS. The LARS score is appropriate for assessments in postoperative bowel function and international comparison. Using this score, patient-reported outcome measures of LARS in Japanese patients can be shared internationally. Additional validation reports from non-English speaking countries can support the LARS score as a worldwide assessment tool for postoperative bowel dysfunction.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
LARS score versus impact in QoL. There was a significant difference between each groups (*p < 0.001, Mann–Whitney U test)
Fig. 2
Fig. 2
ROC curve shows the relation between LARS score and major impact on QoL. Area under the curve = 0.891
Fig. 3
Fig. 3
Comparison of LARS score in a tumor distance to anal verge (*p = 0.018, †p > 0.05), and b type of surgery (*p = 0.008, **p = 0.045, ***p = 0.004) (Mann–Whitney U test)
Fig. 4
Fig. 4
Bland Altman plot with 95% limits of agreement (− 13.4 to 15.4) illustrating the difference between the LARS score at the first and second test
See this image and copyright information in PMC

References

    1. Center for cancer control and information services, National Cancer Center, Japan. http://ganjoho.jp/reg_stat/statistics/stat/summary.html. Accessed 14 Mar 2017
    1. Japanese Society for Cancer of the Colon and Rectum . JSCCR guidelines 2016 for the treatment of colorectal cancer. Tokyo: Kanehara and Co. Ltd; 2016. - PMC - PubMed
    1. Bryant CL, Lunniss PJ, Knowles CH, et al. Anterior resection syndrome. Lancet Oncol. 2012;13:e403–e408. doi: 10.1016/S1470-2045(12)70236-X. - DOI - PubMed
    1. Scheer AS, Boushey RP, Liang S, et al. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum. 2011;54:1589–1597. doi: 10.1097/DCR.0b013e3182214f11. - DOI - PubMed
    1. Chapman SJ, Bolton WS, Corrigan N, et al. A cross-sectional review of reporting variation in postoperative bowel dysfunction after rectal cancer surgery. Dis Colon Rectum. 2016;60:240–247. doi: 10.1097/DCR.0000000000000649. - DOI - PubMed

Publication types