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Original Article
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
Ri Na Yoo, Bong-Hyeon Kye, HyungJin Kim, Gun Kim, Hyeon-Min Cho
Ann Coloproctol. 2023;39(1):32-40.   Published online March 11, 2022
DOI: https://doi.org/10.3393/ac.2021.00696.0099
  • 5,761 View
  • 165 Download
  • 3 Web of Science
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Bowel dysfunction commonly occurs in patients with locally advanced rectal cancer treated with a multimodal approach of chemoradiation therapy (CRT) combined with sphincter-preserving rectal resection. This study investigated the decline in anorectal function using sequential anorectal manometric measurements obtained before and after the multimodal treatment as well as at a 1-year follow-up.
Methods
This was a retrospective cohort study conducted in a single center. The study population consisted of patients with locally advanced mid- to low rectal cancer who received the preoperative CRT followed by sphincter-preserving surgery from 2012 to 2016. The anorectal manometric value measured after each treatment modality was compared to demonstrate the degree of decline in anorectal function. A generalized linear model of repeated measures was performed using the manometric values measured pre- and post-CRT, and at 12 months postoperatively.
Results
Overall, 100 patients with 3 consecutive manometric data were included in the final analysis. In the overall cohort study, the mean resting and maximal squeezing pressures showed insignificant decrement post-neoadjuvant CRT. At a 1-year postoperative follow-up, the maximal squeezing pressure significantly decreased. The maximal rectal sensory threshold demonstrated significant reduction consecutively after each following treatment (P<0.001).
Conclusion
The short-term effect of neoadjuvant CRT on the anal sphincters was relatively trivial. The following sphincter-saving surgery resulted in a profound disruption of the anorectal function. Patients with rectal cancer should be consulted on the consequence of multimodal treatment.

Citations

Citations to this article as recorded by  
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
  • Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
Case Report
Benign GI diease,Benign diesease & IBD
Enterovesical Fistula From Meckel Diverticulum
Seung-Rim Han, Hyung-Jin Kim, Ri Na Yoo, Suk Hyun Shin, Gun Kim, Hyeon Min Cho, Seung-Ju Lee, Hyang-Im Lee
Ann Coloproctol. 2021;37(Suppl 1):S1-S3.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2019.01.18
  • 6,020 View
  • 103 Download
  • 3 Web of Science
  • 3 Citations
AbstractAbstract PDF
Meckel diverticulum is a common congenital malformation of the gastrointestinal tract and can cause complications such as ulceration, hemorrhage, intussusception, and perforation. This report describes a very rare complication of an enterovesical fistula associated with chronic Meckel diverticulum. A 51-year-old male presented with over 10 years of persistent pyuria. Tests were performed to rule out malignancy, including serum prostate-specific antigen level, urine cytology, bacterial culture, cystoscopy, and bladder computed tomography. An enterovesical fistula was identified, and laparoscopic exploration was performed. The findings suggested enterovesical fistula formation caused by chronic inflammation at the tip of a Meckel diverticulum. Segmental resection of the small bowel including the diverticulum and primary repair of the urinary bladder along with partial cystectomy were performed. The postoperative clinical course was uneventful. An enterovesical fistula is a very rare complication resulting from chronic inflammation of a Meckel diverticulum.

Citations

Citations to this article as recorded by  
  • Management of vesicoenteric fistulas arising from perforated Meckel’s diverticulum: a report of a case and review of the literature
    Dimitrios Diamantidis, Nikolaos Papatheodorou, Panagiotis Kostoglou, Georgios Tsakaldimis, Sotirios Botaitis
    Oxford Medical Case Reports.2024;[Epub]     CrossRef
  • The Effects of Diet, Dietary Supplements, Drugs and Exercise on Physical, Diagnostic Values of Urine Characteristics
    Dorota Skrajnowska, Barbara Bobrowska-Korczak
    Nutrients.2024; 16(18): 3141.     CrossRef
  • A case report of a ruptured Meckel's diverticulum with ectopic gastric and pancreatic tissue with negative computed tomography
    Marcos Rosado, Thomas Serena, John Pui, John Parmely
    International Journal of Surgery Case Reports.2021; 83: 105994.     CrossRef
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