Effect of multidimensional nursing on low anterior resection syndrome after sphincter preservation surgery for low rectal cancer

doi:10.4240/wjgs.v17.i10.108596

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Oct 27, 2025 (publication date) through Nov 16, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Gastrointest Surg. Oct 27, 2025; 17(10): 108596
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.108596

Effect of multidimensional nursing on low anterior resection syndrome after sphincter preservation surgery for low rectal cancer

Zheng Ruan, Qun Ye, Ran Yang

Zheng Ruan, Qun Ye, Ran Yang, Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China

Co-first authors: Zheng Ruan and Qun Ye.

Author contributions: Ruan Z and Ye Q contributed equally as co-first authors; They designed the study, oversaw data collection, and participated in manuscript writing; Yang R contributed to data analysis and manuscript drafting; All authors reviewed and approved the final version.

Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Xiamen University, No.[2024] Research Lunshen Zi (157).

Informed consent statement: All study participants and their legal guardians provided written informed consent before recruitment.

Conflict-of-interest statement: The authors declare no conflicts of interest.

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.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Ran Yang, Chief Nurse, Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, No. 55 Zhenhai Road, Siming District, Xiamen 361003, Fujian Province, China. yr15960225210@126.com

Received: May 28, 2025
Revised: June 29, 2025
Accepted: August 20, 2025
Published online: October 27, 2025
Processing time: 148 Days and 23.2 Hours

Abstract

BACKGROUND

According to the Global Cancer Statistics Report, the incidence of colorectal cancer ranks third and the mortality rate ranks second worldwide among malignant tumors.

AIM

To explore the effects of Nursing Outcomes Classification (NOC)-based multidimensional nursing on self-efficacy and symptom relief in patients with low anterior resection syndrome (LARS) following sphincter-preserving surgery.

METHODS

This observational study enrolled 120 patients with LARS after sphincter-preserving surgery for low rectal cancer admitted to our hospital between January 2022 and December 2024. The patients were randomly divided into a control group (n = 60) that received routine nursing intervention or an observation group (n = 60) that received multidimensional nursing intervention. Before and after the intervention, the Chinese version of the Self-Management Efficacy Scale for Cancer Patients (SUPPH), the LARS scoring scale, and the European Organization for Research and Treatment of Cancer Quality of Life Core Scale (EORTC QLQ-C30) were used to evaluate the self-efficacy, symptom relief, and quality of life of the two patient groups, and the nursing satisfaction was compared between the groups.

RESULTS

After the intervention, both groups showed increased scores for each item on the SUPPH and EORTC QLQ-C30 scales compared with those before the intervention, whereas the LARS score showed a decreasing trend. Compared with the control group, the scores for each item of the SUPPH and EORTC QLQ-C30 scales in the observation group were significantly higher after the intervention, while the LARS score was significantly lower (all P < 0.05). Nursing satisfaction was significantly higher in the observation group than in the control group (83.33% vs 95.00%, P < 0.05).

CONCLUSION

Multidimensional NOC-based nursing improves self-efficacy, symptoms, quality of life, and satisfaction in patients with LARS. However, further research is needed to assess its long-term and comparative effectiveness.

Keywords: Low rectal cancer; Surgery; Low anterior resection syndrome; Multidimensional nursing; Self-efficacy; Symptoms

Core Tip: Multidimensional nursing based on the Nursing Outcomes Classification System significantly improves self-efficacy and symptom management in patients with low anterior resection syndrome (LARS) after sphincter-preserving surgery for rectal cancer. By integrating structured education, pelvic floor rehabilitation, and psychological interventions, this approach reduced LARS scores by 40%, enhanced quality of life, and achieved 95% patient satisfaction. Its innovation lies in bridging physiological recovery with psychological resilience through standardized outcome metrics.