Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy

Abstract

Preoperative chemoradiotherapy (PCRT) is a standard treatment for locally advanced rectal cancer. The influence of PCRT on anorectal function has not been objectively assessed. We evaluated the short-term influence of PCRT on anorectal function in patients with locally advanced rectal cancer using anorectal manometry. We included 310 patients with locally advanced mid and lower rectal cancer who underwent PCRT from 2012 to 2015. We compared anorectal function based on anorectal manometry between before and after PCRT according to tumor location, clinical T (cT) stage, and tumor response after PCRT. Lower rectal cancer was common in the cohort of 310 patients (n = 228, 73.5%). Sphincter length (p = 0.003) and maximal resting pressure (p < 0.001) increased and maximal tolerated volume (p = 0.036) decreased after PCRT regardless of tumor location. Maximal squeezing pressure and rectal compliance slightly decreased, without statistical significance. Changes in manometric parameters after PCRT were not associated with changes of cT stage after PCRT. However, minimal sensory volume (p = 0.042) and maximal tolerated volume (p = 0.025) increased significantly in 143 patients (46.1%) with changes in the distance of the cancer from the anal verge after PCRT. PCRT did not impair the overall short-term anorectal manometric parameters in patients with locally advanced rectal cancer. Further study is required to investigate postoperative anorectal function after sphincter-preserving surgery to evaluate the long-term effects of PCRT on anorectal function.

The pattern of bowel dysfunction in patients with rectal cancer following the multimodal treatment: anorectal manometric measurements at before and after chemoradiation therapy, and postoperative 1 year

“…In this study, change in the MRST immediately after CRT showed a decrease in statistical significance. This finding is in accordance with that in previous studies on anorectal function post-CRT in patients with rectal cancer [11,[16][17][18]. To explain the reduced MRST post-CRT, Song et al [18] investigated the acute inflammation and edema caused by radiation exposure to the rectum.…”

“…The manometric data from a small number of patients with midto low rectal cancer reported a significant reduction in anal resting and squeezing pressures measured immediately after CRT [11,17]. Contrarily, a recent study evaluating the change of anorectal function in patients with low rectal cancer demonstrated an increased anal resting pressure and slightly decreased squeezing pressure measured shortly after neoadjuvant CRT [16]. Such a variation can be explained partly by different techniques in anorectal manometry.…”

Clinical benefit of high resolution anorectal manometry for the evaluation of anal function after intersphincteric resection

“…Second, the sample size was relatively small and, in particular, there were few cases of CRT (2/68 patients, 3%). As such we have insufficient data to confirm or refute a possible negative effect of CRT on anorectal function after ISR . Third, the duration of follow‐up was short.…”

The effect of pain-education nursing based on a mind map on postoperative pain score and quality of life in patients with colorectal cancer

“…[24] Pharmacological analgesia, as the main modality for the treatment of colorectal cancer pain, has formed a 3-step analgesic treatment principle. [25][26][27][28] However, a large number of studies have found that the therapeutic effect of long-term analgesic drugs is not ideal, and the incidence of adverse reactions in patients after treatment is relatively high, which not only affects the clinical treatment but also has a great impact on the quality of life of patients. [29] The use of mind mapping in the health education of cancer patients to evaluate the level of pain, medication compliance, and patient satisfaction has enabled patients to control their pain and acquire knowledge about medication after the intervention.…”