Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Luo, Biao; Zheng, Min; Yang, Xia; Zhu, Ying; Peng, Jianhong; Li, Liren; Pan, Zhizhong; Qin, Huiying

doi:10.1016/j.ejon.2021.102059

Cited by 3 publications

(5 citation statements)

References 35 publications

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“…Активность гладкой мускулатуры внутреннего анального сфинктера поддерживает давление в анальном канале в состоянии покоя. В то время как поперечнополосатая мускулатура наружного анального сфинктера и тазового дна участвует в осуществлении произвольного сокращения, особенно в течение длительного периода [23]. Скоординированное функционирование анальных сфинктеров и ампулы прямой кишки обеспечивает возможность адекватного осуществления запирательной функции [24].…”

Section: Discussionunclassified

Features of anorectal function after radiation therapy in patients with rectal cancer

Kit,

Bondarenko,

Gevorkyan

et al. 2024

jour

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Purpose of the study. To study the function of the sphincter in patients with rectal cancer after chemoradiotherapy using the method of high-resolution anorectal manometry.Materials and methods. The study included 30 patients with cancer of the middle and lower ampullary rectum, who underwent combined treatment at the National Medical Research Center of Oncology. The patients underwent a course of neoadjuvant gamma radiation therapy using capecitabine. High-resolution anorectal manometry was performed before the start of treatment and 2 months after completion of chemoradiotherapy to study the functional parameters of the sphincter apparatus. The severity of anorectal dysfunction was assessed using the Wexner anal incontinence scale.Results. According to high-resolution anorectal manometry, the average pressure of the anal canal at rest decreased by 1.4 times (p < 0.05), and the average absolute compression pressure with voluntary contraction decreased by 1.2 times (p = 0.0012) after neoadjuvant chemoradiotherapy. A comparative assessment of the maximum absolute compression pressure at this stage of treatment did not allow us to trace a significant difference between its value before the start of radiation therapy and 2 months after its completion (p > 0.05). An increase in threshold sensitivity volumes was noted in 23 patients (p = 0.16). The use of the Wexner scale didn’t show a statistically significant change in the median scores according to the results of patient surveys following the completion of treatment (5.2 vs. 5.5 points, p > 0.05).Conclusions. Radiation therapy has an effect on anorectal function, which may contribute to the occurrence of low anterior resection syndrome after surgical treatment. For this reason, it is now necessary to carefully consider the risks of developing anorectal dysfunction. Equally important is the use of methods for the prevention of low anterior resection syndrome for patients who have received combined treatment for rectal cancer.

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Section: Discussionunclassified

Features of anorectal function after radiation therapy in patients with rectal cancer

Kit,

Bondarenko,

Gevorkyan

et al. 2024

jour

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“…В исследовании Bao-Jia Luo et al (2021 г.) у 27 % пациентов частота стула составляла более 5 раз в день, а у 30 % больных возникали императивные позывы, связанные с изменением эвакуаторной функции сфинктерного аппарата [9]. При этом длительность функциональных нарушений может быть кратковременной и продолжаться в течение 6-12 месяцев или долгосрочной с сохранением симптоматики более 1 года [10; 11].…”

Section: результатыunclassified

“…Послеоперационный дисбиоз с тенденцией к значительному уменьшению разнообразия кишечной микробиоты коррелирует с повышенной частотой стула независимо от эндоскопической активности воспалительного процесса. Согласно некоторым источникам, учащение дефекации возникает при дисбалансе состава микробиоты со снижением относительного количества Bacteroidetes и увеличением Enterobacteriaceae [37].…”

Section: факторы рискаunclassified

“…Sun W et al (2019 г.) описывают илеостому, как независимый фактор риска выраженного СНПР (ОШ = 2,59 (95 % ДИ: 1,27-5,30), p = 0,009) [37]. В исследовании Hughes D. L. et al (2017 г.)…”

Section: методы оценки снпрunclassified

“…В исследовании Luo B. et al (2021 г.) наблюдалось снижение физиологических параметров аноректальной зоны после низкой передней резекции прямой кишки у 146 пациентов [9]. Наибольшие изменения проявлялись в снижении показателей анального давления покоя, максимального давления сжатия, максимально переносимого объёма (р < 0,001).…”

Section: методы оценки снпрunclassified

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Low anterior resection syndrome and methods of its assessment (literature review)

Bondarenko,

Gevorkyan,

Soldatkina

et al. 2023

jour

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Low anterior resection syndrome is a common problem due to the increased incidence of rectal cancer and the high incidence of anorectal dysfunction during sphincter-preserving surgical interventions. The influence of functional disorders on the quality of life of patients and changes in social adaptation makes it possible to attribute the syndrome of low anterior resection to topical and discussed issues.Purpose of the study: to consider the features of the development of anorectal dysfunction in patients with rectal cancer by studying risk factors and pathogenetic aspects of the development of low anterior resection syndrome, as well as to evaluate the role of objective studies in assessing the syndrome according to published literature. The etiology of low anterior resection syndrome is multifactorial. Unmodified and modified predictors are distinguished among the risk factors. Unmodified factors include female gender and age over 65 years. Among the modifiable predictors, radiation therapy, surgical intervention, the type of formed colorectal anastomosis and the development of its insolvency, as well as the elimination of intestinal stoma have a negative effect on anorectal function. Nevertheless, the greatest role in its development is played by organ-preserving surgery with total mesorecumectomy, radiation therapy and the formation of a preventive ileostomy. The complexity of the pathophysiological mechanism of the syndrome necessitates a detailed study of anorectal function and changes in its parameters in patients during treatment for rectal cancer. Functional disorders in low anterior resection syndrome vary in severity. In the study of the severity of clinical manifestations of the syndrome, the use of the LARS scale is important, and in the development of anal incontinence, the use of the Wexner scale is important. However, the most accurate assessment can be carried out by objective research methods, such as high-resolution anorectal manometry. This research method allows to control the function of the rectal obturator apparatus at different stages of combined treatment and unwraps the possibility of searching for new predictors of low anterior resection syndrome.

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Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner

et al. 2023

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Background For breast cancer patients, the partner’s support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner’s personal project support and women’s well-being. Methods A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used. Results Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner’s emotional project support was predictive of women’s relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control. Conclusions Our results highlight the importance of involving women’s subjective perspectives regarding the partner’s project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem.

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Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study

Cited by 3 publications

References 35 publications

Features of anorectal function after radiation therapy in patients with rectal cancer

Features of anorectal function after radiation therapy in patients with rectal cancer

Low anterior resection syndrome and methods of its assessment (literature review)

Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner

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