BACKGROUND AND AIMS: Neoadjuvant chemoradiation (nCRT) followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. This prospective study evaluates the effect of nCRT on postoperative anorectal function and continence. PATIENTS AND METHODS: Group A consisted of 12 patients (59.8 +/- 11.9 years, male:female = 8:4) who received nCRT (5-FU, CPT-11. 45 + 5.4 Gy boost) before surgery and Group B of 27 patients (61.9 +/- 10.6 years, male:female = 16:11) who were treated by surgery alone. All patients received a questionnaire to evaluate stool continence and anorectal function before as well as after surgery. Anorectal function was further analyzed by perfusion manometry pre- and postoperatively. RESULTS: Preoperatively, none of the patients had signs or symptoms of fecal incontinence, and preoperative measurements showed values within normal limits. Postoperatively, fecal continence was impaired in both groups, but no significant difference was found between patients with or without nCRT. Anorectal manometry revealed an impairment of anorectal function after low anterior resection regardless of the treatment regime. CONCLUSION: nCRT does not impair anorectal function and fecal continence. The deterioration of continence and anal sphincter function after sphincter preserving surgery is solely caused by the surgical procedure.
BACKGROUND AND AIMS: Neoadjuvant chemoradiation (nCRT) followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. This prospective study evaluates the effect of nCRT on postoperative anorectal function and continence. PATIENTS AND METHODS: Group A consisted of 12 patients (59.8 +/- 11.9 years, male:female = 8:4) who received nCRT (5-FU, CPT-11. 45 + 5.4 Gy boost) before surgery and Group B of 27 patients (61.9 +/- 10.6 years, male:female = 16:11) who were treated by surgery alone. All patients received a questionnaire to evaluate stool continence and anorectal function before as well as after surgery. Anorectal function was further analyzed by perfusion manometry pre- and postoperatively. RESULTS: Preoperatively, none of the patients had signs or symptoms of fecal incontinence, and preoperative measurements showed values within normal limits. Postoperatively, fecal continence was impaired in both groups, but no significant difference was found between patients with or without nCRT. Anorectal manometry revealed an impairment of anorectal function after low anterior resection regardless of the treatment regime. CONCLUSION: nCRT does not impair anorectal function and fecal continence. The deterioration of continence and anal sphincter function after sphincter preserving surgery is solely caused by the surgical procedure.
Authors: E Kapiteijn; C A Marijnen; I D Nagtegaal; H Putter; W H Steup; T Wiggers; H J Rutten; L Pahlman; B Glimelius; J H van Krieken; J W Leer; C J van de Velde Journal: N Engl J Med Date: 2001-08-30 Impact factor: 91.245
Authors: P Gervaz; N Rotholtz; S D Wexner; S Y You; N Saigusa; E Kaplan; M Secic; E G Weiss; J J Nogueras; B Belin Journal: Dis Colon Rectum Date: 2001-11 Impact factor: 4.585
Authors: Eric E K Yeoh; Richard H Holloway; Robert J Fraser; Rochelle J Botten; Addolorata C Di Matteo; James W E Moore; Mark N Schoeman; F Dylan L Bartholomeusz Journal: Am J Gastroenterol Date: 2004-02 Impact factor: 10.864
Authors: Aras Emre Canda; Cem Terzi; Ilknur B Gorken; Ilhan Oztop; Selman Sokmen; Mehmet Fuzun Journal: Int J Colorectal Dis Date: 2009-09-26 Impact factor: 2.571
Authors: Jin Sook Song; In Ja Park; Jeong Hye Kim; Hyang Ran Lee; Jeong Rang Kim; Jong Lyul Lee; Yong Sik Yoon; Chan Wook Kim; Seok Byung Lim; Chang Sik Yu; Jin Cheon Kim Journal: Oncotarget Date: 2017-08-27