Validação para o brasil do escore "LARS" de avaliação da síndrome pós-ressecção anterior do reto

Abstract

INTRODUCTION: The population with bowel dysfunction due to theprocedures for treatment of rectal cancer has increased in the recent decades. Anatomical and functional changes after the removal of the rectum lead to increased stool frequency, urgency, multiple evacuations and flatus or stool incontinence characterizing the low anterior resection syndrome - LARS. In 2012 the LARS score was published for the assessment of bowel function after surgeries for treatment of colorectal cancer which is still not validated in Brazil. AIM: To perform the translation, cultural adaptation and validation of LARS score for Brazil. METHODS: The translation and cultural adaptation of LARS score for the brazilian portuguese language followed the international recommendations of the World Health Organization and The European Organization for Research and Treatment of Cancer (EORTC). The questionnaire was completed by 127 patients. Convergent validity was verified by comparing the brazilian version of LARS score with the EORTC QLQ-C30 quality of life questionnaire and with the patient`s self-reported quality of life.The discriminative validity of the score was investigated by comparing groups of patients expected to have worse functional outcomes due to themechanisms of LARS. The intraobserver and interobserver reproducibility were assessed in respective subgroups of 36 and 31 patients who fulfilled the questionnaire once again. RESULTS: The Brazilian version of LARS score showed correlation with five of the six items of the EORTC QLQ-C30 analyzed (p < 0.05) and agreement with the quality of life reported by patients in 95.3% of cases. The LARS score was able to discriminate symptoms showing worse funcpreoperative radio and chemotherapy, with tumors up to five centimeters from the anal verge and when performed total mesorectal excision (p < 0.001). In the assessment of intraobserver (p = 0.8) and interobservers (p = 0.2) reproducibility there was no difference between the replies of the score. The intraclass correlation coefficients were 0.94 and 0.92, respectively. CONCLUSION: The Brazilian version of LARS score is an easy implementation tool for assessing bowel function and has suitable convergent and discriminant validity and reproducibility for validationtional outcomes in patients with poor quality of life, whose underwent to