Many patients develop a variety of bowel dysfunction after sphincter preserving surgeries (SPS) for rectal cancer. The bowel
dysfunction usually manifests in the form of low anterior resection syndrome (LARS), which has a negative impact on the patients’
quality of life. This study reviewed the LARS after SPS, its mechanism, risk factors, diagnosis, prevention, and treatment based on
previously published studies. Adequate history taking, physical examination of the patients, using validated questionnaires and
other diagnostic tools are important for assessment of LARS severity. Treatment of LARS should be tailored to each patient.
Multimodal therapy is usually needed for patients with major LARS with acceptable results. The treatment includes conservative
management in the form of medical, pelvic floor rehabilitation and transanal irrigation and invasive procedures including
neuromodulation. If this treatment failed, fecal diversion may be needed. In conclusion, Initial meticulous dissection with preservation
of nerves and creation of a neorectal reservoir during anastomosis and proper Kegel exercise of the anal sphincter can minimize the
occurrence of LARS. Pre-treatment counseling is an essential step for patients who have risk factors for developing LARS.