Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 09 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: "High-output stoma after surgery for rectal cancer - A risk factor for Low Anterior Resection
Syndrome?"
This manuscript addresses an important clinical question regarding the relationship between
high-output stoma (HOS) and low anterior resection syndrome (LARS) in patients undergoing
rectal cancer surgery. The study design, focused on subgroup analysis and multivariable
modeling, is appropriate and well-executed. The findings provide valuable insights into the
potential impact of HOS on postoperative quality of life and clinical outcomes.
The introduction effectively sets the stage, detailing the clinical significance of both HOS and
LARS. The methodology is transparent, with clear descriptions of statistical adjustments in
multivariable models. The results are compelling, particularly the robust association between
HOS and LARS, even after adjustment for relevant covariates. Tables and figures are well-
organized and enhance the understanding of your findings.
Strengths:
The association between HOS and LARS is presented with robust statistical support.
Tables and figures are clear, with meaningful visual representation of key relationships.
The study highlights an underexplored area, offering new perspectives on postoperative care in
rectal cancer surgery.
Minor Recommendations:
Consider expanding the discussion on the implications of early intervention strategies for
patients at risk of HOS to reduce LARS incidence.
Provide a brief acknowledgment of the need for prospective validation in future research.
Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 09 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: "High-output stoma after surgery for rectal cancer - A risk factor for Low Anterior Resection
Syndrome?"
This manuscript addresses an important clinical question regarding the relationship between
high-output stoma (HOS) and low anterior resection syndrome (LARS) in patients undergoing
rectal cancer surgery. The study design, focused on subgroup analysis and multivariable
modeling, is appropriate and well-executed. The findings provide valuable insights into the
potential impact of HOS on postoperative quality of life and clinical outcomes.
The introduction effectively sets the stage, detailing the clinical significance of both HOS and
LARS. The methodology is transparent, with clear descriptions of statistical adjustments in
multivariable models. The results are compelling, particularly the robust association between
HOS and LARS, even after adjustment for relevant covariates. Tables and figures are well-
organized and enhance the understanding of your findings.
Strengths:
The association between HOS and LARS is presented with robust statistical support.
Tables and figures are clear, with meaningful visual representation of key relationships.
The study highlights an underexplored area, offering new perspectives on postoperative care in
rectal cancer surgery.
Minor Recommendations:
Consider expanding the discussion on the implications of early intervention strategies for
patients at risk of HOS to reduce LARS incidence.
Provide a brief acknowledgment of the need for prospective validation in future research.
Please review this paper.
user
Title: High output stoma after surgery for rectal cancer - A risk factor for Low Anterior
Resection Syndrome?
Version: 1 Date: 09 Dec 2024
Reviewer:  Mohamed H. Zidan
Reviewer's report:
Dear Authors,
Re: "High-output stoma after surgery for rectal cancer - A risk factor for Low Anterior Resection
Syndrome?"
This manuscript addresses an important clinical question regarding the relationship between
high-output stoma (HOS) and low anterior resection syndrome (LARS) in patients undergoing
rectal cancer surgery. The study design, focused on subgroup analysis and multivariable
modeling, is appropriate and well-executed. The findings provide valuable insights into the
potential impact of HOS on postoperative quality of life and clinical outcomes.
The introduction effectively sets the stage, detailing the clinical significance of both HOS and
LARS. The methodology is transparent, with clear descriptions of statistical adjustments in
multivariable models. The results are compelling, particularly the robust association between
HOS and LARS, even after adjustment for relevant covariates. Tables and figures are well-
organized and enhance the understanding of your findings.
Strengths:
The association between HOS and LARS is presented with robust statistical support.
Tables and figures are clear, with meaningful visual representation of key relationships.
The study highlights an underexplored area, offering new perspectives on postoperative care in
rectal cancer surgery.
Minor Recommendations:
Consider expanding the discussion on the implications of early intervention strategies for
patients at risk of HOS to reduce LARS incidence.
Provide a brief acknowledgment of the need for prospective validation in future research.
assistant