Case Report: Quantitative and qualitative evaluation for electroacupuncture combined with moxibustion in the treatment of recalcitrant low anterior resection syndrome

Background Approximately 60–80% of rectal cancer patients develop low anterior resection syndrome (LARS) following sphincter-preserving surgery, which significantly impacts their quality of life. Existing treatments have various limitations. This case report evaluated the efficacy of electroacupuncture (EA) combined with moxibustion therapy for refractory LARS using a combined quantitative and qualitative approach. The patient was a 55-year-old man who continued to experience severe symptoms (LARS score: 34 points) 8 years after rectal cancer surgery, with sacral nerve modulation treatment proving ineffective. Case presentation The patient received EA and moxibustion treatment between 5 December 2024 and 27 December 2024. EA was administered every other day (12 sessions total), targeting the bilateral sacral foramen acupoints: Shangliao (BL31), Ciliao (BL32), Zhongliao (BL33), and Xialiao (BL34). Electrical stimulation lasted 30 min per session with a continuous wave at 50 Hz. Daily moxibustion (23 sessions total) was applied to Shenshu (BL23) and Mingmen (DU4) to warm the kidneys and strengthen the yang. Moxa sticks (30 mm diameter) were held 2 cm above the skin for 45 min per session. After treatment, the LARS score decreased to 11. Daily defecation frequency reduced from 13–15 to 3–4 episodes. Qualitative interview results showed that urgency tolerance increased (from <1 min to 10 min), fecal leakage frequency decreased (from ≥1 daily to <1 weekly), and there was improvement in evacuation difficulties and flatus control. Systemic symptoms (cold extremities, abdominal distension) improved. However, therapeutic effects partially relapsed at 3 months and stabilized at minor LARS levels (score 24) through 1-year follow-up. Conclusion By combining quantitative and qualitative outcome assessments, this case report offers initial evidence for short-term symptom management in refractory LARS. High-quality research is still needed to fully assess the efficacy of this treatment.