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World J Gastroenterol. Apr 28, 2026; 32(16): 116405
Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.116405
Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.116405
Longitudinal evolution of low anterior resection syndrome in ultra-low rectal cancer: A trend analysis of a propensity-matched cohort
Han-Shuo Wang, Yu-Xin Lin, Si-Rui Xu, West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Han-Shuo Wang, Li-Ya Wang, Xiao-Dong Wang, Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ming-Jun Huang, Day Surgery Center of General Practice Medical Center/West China School of Nursing, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Co-corresponding authors: Xiao-Dong Wang and Ming-Jun Huang.
Author contributions: Wang XD and Huang MJ contribute equally to this study as co-corresponding authors; Wang HS, Wang LY, Wang XD, and Huang MJ conceived and designed the study; Wang XD was responsible for providing study materials and patient recruitment; data were collected and assembled by Lin YX and Xu SR; Wang HS performed the statistical analysis; the initial manuscript was drafted by Wang HS, Lin YX, and Xu SR; Wang XD, Wang LY, and Huang MJ critically revised the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by Clinical Research Incubation Project of West China Hospital of Sichuan University, No. 2021HXFH052; and 1·3·5 Projects for Artificial Intelligence of West China Hospital of Sichuan University, No. ZYAI24067.
Institutional review board statement: This study was conducted in strict accordance with the Declaration of Helsinki and was approved by the Ethics Committee on Biomedical Research of West China Hospital of Sichuan University (Approval No. 2020-832). The data collection for this study was performed within a comprehensive, ongoing prospective cohort framework at our institution. This framework is supported by several foundational ethics approvals from the same committee, including the “colorectal cancer database application analysis” (Approval No. 2019-140), “value-based healthcare-oriented full-lifecycle cohort study of colorectal cancer” (Approval No. 2021-155), and “multicenter data cohort construction and data mining based on value-based healthcare colorectal cancer standard dataset” (Approval No. 2023-669).
Informed consent statement: Signed informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Xiao-Dong Wang, MD, PhD, Professor, Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received: November 11, 2025
Revised: January 20, 2026
Accepted: February 10, 2026
Published online: April 28, 2026
Processing time: 157 Days and 13.1 Hours
Revised: January 20, 2026
Accepted: February 10, 2026
Published online: April 28, 2026
Processing time: 157 Days and 13.1 Hours
Core Tip
Core Tip: Parallel recovery trajectory: After propensity score matching, the ultra-low and non-ultra-low rectal cancer groups shared a similar rate of functional improvement throughout the first postoperative year. Persistently higher risk: Despite the similar recovery pace, the ultra-low group consistently faced a significantly higher overall risk of low anterior resection syndrome (LARS), attributable to a worse initial functional baseline. Clinical implication: These findings establish tumor height as a critical, independent determinant of LARS, underscoring the need for tailored counseling and proactive management strategies for patients with ultra-low tumors.