Introduction/Background Cytoreductive surgery combined with platinum-based chemotherapy is the standard treatment for advanced stage epithelial ovarian cancer (EOC). A Low Anterior Resection (LAR) can be necessary to achieve complete cytoreductive surgery. Low anterior resection syndrome (LARS) is a well- known long-term complication in rectal cancer patients undergoing a LAR but evidence on prevalence of LARS in ovarian cancer patients is limited. The aim of this study is to investigate the prevalence of LARS in a cohort of patients with advanced stage epithelial ovarian cancer after a LAR.

Methodology This is a single-center mixed methods study design consisting of a literature overview, a retrospective chart study and qualitative semi-structured interviews. Patients with advanced stage epithelial ovarian cancer who had primary or interval cytoreductive surgery including LAR were included. Main outcome was the postoperative LARS-score and postoperative documentation of functional bowel symptoms and impact on quality of life.

Results Forty-seven patients who underwent debulking surgery with a LAR between 2009 and 2019 were included for retrospective chart analysis. The LARS-score could not be determined retrospectively except in one case, because of non-specific documentation about defecation. However, in the majority of patients (76.6%) evidence of functional bowel symptoms was found. We interviewed nine patients for the interview part of the study. One patient suffered from major LARS, three patients from minor LARS. Qualitative analysis showed evidence for significant impact of LARS on quality of life.

Conclusion Evidence on LARS in EOC patients is limited. This study contributes to creating attention and awareness for postoperative functional bowel problems. Prospective research is recommended in order to gain more insight in prevalence and impact on quality of life of LARS in patients with epithelial ovarian cancer after cytoreductive surgery.