Clinical Research Papers:
Peri-treatment change of anorectal function in patients with rectal cancer after preoperative chemoradiotherapy
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Jin Sook Song1, In Ja Park2, Jeong Hye Kim3, Hyang Ran Lee1, Jeong Rang Kim1, Jong Lyul Lee2, Yong Sik Yoon2, Chan Wook Kim2, Seok Byung Lim2, Chang Sik Yu2 and Jin Cheon Kim2
1 Department of Colorectal Clinic, Asan Medical Center, Seoul, Korea
2 Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3 Department of Clinical Nursing, University of Ulsan, Seoul, Korea
In Ja Park, email:
Jeong Hye Kim, email:
Keywords: anorectal manometry, anorectal function, preoperative chemoradiotherapy, rectal cancer
Received: March 29, 2017 Accepted: August 15, 2017 Published: August 27, 2017
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.
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