Long-Term Anorectal Dysfunction After Postoperative Radiotherapy for Rectal Cancer

Lundby, Lilli; Krogh, Klaus; Jensen, Viggo A.; Gandrup, Per; Qvist, Niels; Overgaard, Jens; Laurberg, Søren

doi:10.1007/s10350-005-0049-1

Cited by 116 publications

(76 citation statements)

References 46 publications

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“…The mechanism seems to be related to direct nerve lesion and pelvic fibrosis induced by pelvic irradiation. This treatment can also cause sexual and urinary dysfunctions due to nerve lesion 20,21 . Patients with LARS also present sensitivity diminishing of recto-anal transition, with prejudice to discriminate liquid and gas, affecting the rectoanal inhibitory reflex and the mechanisms of stool continence 11 .…”

Section: Lars Physiopathologymentioning

confidence: 99%

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal

Buzatti

Petroianu

2017

Rev. Col. Bras. Cir.

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RESUMO O número de pacientes com distúrbios funcionais intestinais em decorrência das operações para o tratamento do câncer retal tem aumentado durantes as últimas décadas. Alterações anatômicas e funcionais após a retirada do reto provocam aumento da frequência evacuatória, urgência evacuatória, evacuações múltiplas e incontinência para fezes e flatos, caracterizando a síndrome da ressecção anterior baixa ou LARS - "low anterior resection syndrome". Este artigo apresenta uma revisão geral do tema, com ênfase para conceitos atuais e aspectos fisiopatológicos de distúrbios funcionais do intestino após o tratamento cirúrgico do câncer retal. É fundamental que o cirurgião compreenda esses mecanismos, para melhor abordagem dos pacientes e restabelecimento da sua qualidade de vida.

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Section: Lars Physiopathologymentioning

confidence: 99%

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal

Buzatti

Petroianu

2017

Rev. Col. Bras. Cir.

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“…19 Some degree of improvement with time is the norm, but symptoms can persist as late as 15 years postoperatively. 20 Postoperative factors contributing to the development of LARS include shortened intestinal length and a diminished rectal reservoir as higher volumes of more liquid stool are delivered to a smaller neorectum. Anorectal manometry reveals reductions in urgent volume, maximal tolerable volume, and rectal compliance.…”

Section: Function After Low Anterior Resectionmentioning

confidence: 99%

Sphincter-Sparing Surgery in Patients with Low-Lying Rectal Cancer: Techniques, Oncologic Outcomes, and Functional Results

Bordeianou

Maguire

Alavi

et al. 2014

Journal of Gastrointestinal Surgery

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Background Rectal cancer management has evolved into a complex multimodality approach with survival, local recurrence, and quality of life parameters being the relevant endpoints. Surgical treatment for low rectal cancer has changed dramatically over the past 100 years. Discussion Abdominoperineal resection, once the standard of care for all rectal cancers, has become much less frequently utilized as surgeons devise and test new techniques for preserving the sphincters, maintaining continuity, and performing oncologically sound ultra-low anterior or local resections. Progress in rectal cancer surgery has been driven by improved understanding of the anatomy and pathophysiology of the disease, innovative surgical technique, improved technology, multimodality approaches, and increased appreciation of the patient's quality of life. The patient with a low rectal cancer, once almost universally destined for impotence and a colostomy, now has the real potential for improved survival, avoidance of a permanent stoma, and preservation of the normal route of defecation.Keywords Rectal cancer . Sphincter preservation . Total mesorectal excision . Anterior resection . Intersphincteric resection . Local excision rectal cancer Historical BackgroundThe modern era of rectal cancer surgery began with the description of the abdominoperineal resection (APR) by Miles in 1908. Prior perineal and sacral approaches (e.g., Kraske approach) to rectal cancer resection produced high rates of complications, cancer recurrence, poor quality of life (QOL), and poor overall survival. Miles' operation reflected greater understanding of the natural history of rectal cancer that was based on postmortem examination of his patients after perineal resection. He observed cancerous implants in the pelvic peritoneum, mesorectum, and affected nodes of the left common iliac bifurcation. These findings led him to develop a "cylindrical concept" of the spread of rectal cancer to upward, downward, and lateral zones. 1 The original operation included resection of the rectum, sigmoid, mesorectum, nodes of the iliac bifurcation, and a perineal component to include the anus and levator ani muscles. Postoperative mortality was high initially, but local recurrence decreased

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“…Several trials established significantly worse continence in patients who underwent adjuvant radiotherapy compared with patients without radiotherapy (81,97). Poorer continence manifested itself as more frequent bowel movement, more frequent urge and soiling.…”

Section: Adjuvant and Neoadjuvant Radio-and Radio-chemotherapy And Dymentioning

confidence: 99%

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

Gross¹

2011

Rectal Cancer - A Multidisciplinary Approach to Management

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Long-Term Anorectal Dysfunction After Postoperative Radiotherapy for Rectal Cancer

Abstract: Adjuvant postoperative radiotherapy after anterior resection causes severe long-term anorectal dysfunction, which is mainly the result of a weakened, less sensitive anal sphincter and an undistensible rectum with reduced capacity.

Cited by 116 publications

References 46 publications

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal

Sphincter-Sparing Surgery in Patients with Low-Lying Rectal Cancer: Techniques, Oncologic Outcomes, and Functional Results

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

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