SP 11.10 Transanal Irrigation for Low Anterior Resection Syndrome: A Systematic Review and Meta-analysis of Bowel Function, Quality of Life, and Patient Satisfaction Outcomes

Abstract Background Low Anterior Resection Syndrome (LARS) is a frequent complication after rectal cancer surgery, causing bowel dysfunction that significantly affects quality of life. Transanal irrigation (TAI) has been proposed as a management option, but existing evidence is scattered. Methods A systematic search of PubMed, Scopus, and Web of Science was conducted from inception to October 2025. RCTs were assessed using the Cochrane Risk of Bias 2.0 tool and observational studies with the Newcastle–Ottawa Scale. Extracted outcomes included LARS and Wexner scores, bowel symptom severity, fecal incontinence, SF-36 quality-of-life measures, and patient satisfaction using a visual analog scale (VAS). Results Ten studies (483 patients) were included, comprising four RCTs and six observational studies. TAI significantly improved bowel function compared with control. LARS scores were reduced at 3 months (MD = −11.15; 95% CI −15.67 to −6.62) and remained lower up to ≥12 months. Wexner scores improved at 3, 6, and 12 months (MD = −2.18, −2.30, and −2.66). TAI also lessened bowel symptom severity and fecal incontinence at all reported intervals. SF-36 scores improved across key domains, including Physical Functioning (MD = 15.61), General Health (MD = 16.24), and Mental Health (MD = 11.12). Patient satisfaction increased over time, with VAS improvements of 2.0 at 3 months, 4.96 at 6 months, and 5.20 at 12 months. Conclusion TAI provides significant and sustained improvements in bowel function, quality of life, and patient satisfaction in patients with LARS, supporting its use as an effective therapeutic strategy.