Peter Ihnát1,2, Ivana Slívová1,2, Lubomir Tulinsky1,2, Lucia Ihnát Rudinská3, Jan Máca4, Igor Penka1,2. 1. Department of Surgery, University Hospital Ostrava, Ostrava, Czech Republic. 2. Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. 3. Department of Forensic Medicine, University Hospital Ostrava, Ostrava, Czech Republic. 4. Department of Anaesthesiology and Resuscitation, University Hospital Ostrava, Ostrava, Czech Republic.
Abstract
BACKGROUND AND OBJECTIVES: The aim was to evaluate the impact of radiotherapy (RT) on anorectal function of patients with low rectal cancer undergoing low anterior resection (LAR). METHODS: Prospective clinical cohort study conducted to assess the functional outcome by means of high-resolution anorectal manometry and LARS score. RESULTS: In total, 65 patients were enrolled in the study (27 patients underwent LAR without RT, 38 patients underwent RT and LAR). There were no statistically significant differences between study subgroups regarding demographic and clinical data; postoperative morbidity was significantly higher in irradiated patients. One year after the surgery, mean LARS score was significantly higher in patients who underwent RT and surgery. Major LARS was detected in 37.0% of irradiated patients and in 14.8% of patients after surgery alone. Anorectal manometry revealed significantly lower resting pressures in patients after RT and LAR; the squeeze pressures were similar. Rectal compliance and all volumes describing rectal sensitivity (first sensation, urge to defecate, and discomfort volume) were significantly lower in irradiated patients. CONCLUSIONS: RT significantly deteriorates the functional outcome of patients after LAR. Manometry revealed internal sphincter dysfunction, reduced capacity, and compliance of neorectum, which seem to have a significant correlation with LARS presence/seriousness.
BACKGROUND AND OBJECTIVES: The aim was to evaluate the impact of radiotherapy (RT) on anorectal function of patients with low rectal cancer undergoing low anterior resection (LAR). METHODS: Prospective clinical cohort study conducted to assess the functional outcome by means of high-resolution anorectal manometry and LARS score. RESULTS: In total, 65 patients were enrolled in the study (27 patients underwent LAR without RT, 38 patients underwent RT and LAR). There were no statistically significant differences between study subgroups regarding demographic and clinical data; postoperative morbidity was significantly higher in irradiated patients. One year after the surgery, mean LARS score was significantly higher in patients who underwent RT and surgery. Major LARS was detected in 37.0% of irradiated patients and in 14.8% of patients after surgery alone. Anorectal manometry revealed significantly lower resting pressures in patients after RT and LAR; the squeeze pressures were similar. Rectal compliance and all volumes describing rectal sensitivity (first sensation, urge to defecate, and discomfort volume) were significantly lower in irradiated patients. CONCLUSIONS: RT significantly deteriorates the functional outcome of patients after LAR. Manometry revealed internal sphincter dysfunction, reduced capacity, and compliance of neorectum, which seem to have a significant correlation with LARS presence/seriousness.
Authors: Paul Sargos; Mame Daro Faye; Manon Bacci; Stéphane Supiot; Igor Latorzeff; David Azria; Tamim M Niazi; Te Vuong; Véronique Vendrely; Renaud de Crevoisier Journal: Front Oncol Date: 2021-06-16 Impact factor: 6.244
Authors: Michał M Nowakowski; Mateusz Rubinkiewicz; Natalia Gajewska; Grzegorz Torbicz; Michał Wysocki; Piotr Małczak; Piotr Major; Mateusz Wierdak; Andrzej Budzyński; Michał Pędziwiatr Journal: Wideochir Inne Tech Maloinwazyjne Date: 2018-07-03 Impact factor: 1.195