EFFECTIVENESS OF PELVIC FLOOR EXERCISE TO PREVENT LARS (LOW ANTERIOR RESECTION SYNDROME) AFTER MINI-INVASIVE LOW ANTERIOR RESECTION IN PATIENTS WITH RECTAL CANCER. Adherence to prescribed home exercise. Quality of life after low anterior resection.

Advances in the surgical treatment of rectal diseases lead to better oncological results, a higher chance of preserving the sphincters, and thus a lower number of permanent stomas. However, the preserved anus does not always have to perform its original function fully. All patients after a low anterior resection are at risk of developing functional disorders - low anterior resection syndrome (LARS). The prevalence of LARS ranges from 41-80% and is a significant factor in reducing the quality of life. According to the available data, it is possible to prevent LARS through postoperative pelvic floor exercises, however, relevant studies are missing. The pelvic floor is a ligament-muscle system that provides dynamic support for the organ systems located in the small pelvis. Strengthening the muscles can serve as a follow-up treatment after surgical procedures including prevention of LARS.

The main goal of this randomized study will be to determine the effectiveness of pelvic floor exercises on the incidence or severity of LARS in patients after mini-invasive rectal resection. Secondary goal is to identify the adherence of patients to prescribed home exercise and quality of life. 

Researchers will compare the group of patients with pelvic floor exercises to those without. Under the professional guidance of a physiotherapist, participants will be educated the day before surgery and in the first 4 postoperative days to exercise the pelvic floor exercise and continue at home for a month. The resulting knowledge will have a fundamental impact on clinical practice and patient management.