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- Title
Evaluation of anorectal function using real-time tissue elastography before and after preoperative chemoradiotherapy.
- Authors
Sakamoto, Akira; Sasaki, Kazuhito; Nozawa, Hiroaki; Murono, Koji; Emoto, Shigenobu; Yokoyama, Yuichiro; Matsuzaki, Hiroyuki; Nagai, Yuzo; Abe, Shinya; Shinagawa, Takahide; Sonoda, Hirofumi; Ishihara, Soichiro
- Abstract
Purpose: This study aimed to clarify the relationship between changes in elasticity and anorectal function before and after chemoradiotherapy. Methods: This is a single-center prospective cohort study (Department of Surgical Oncology, The University of Tokyo). We established a technique to quantify internal anal sphincter hardness as elasticity using transanal ultrasonography with real-time tissue elastography. Twenty-seven patients with post-chemoradiotherapy rectal cancer during 2019–2022 were included. Real-time tissue elastography with transanal ultrasonography was performed before and after chemoradiotherapy to measure internal anal sphincter hardness as "elasticity" (hardest (0) to softest (255); decreased elasticity indicated sclerotic changes). The relationship between the increase or decrease in elasticity pre- and post-chemoradiotherapy and the maximum resting pressure, maximum squeeze pressure, and Wexner score were the outcome measures. Results: A decrease in elasticity was observed in 16/27 (59.3%) patients after chemoradiotherapy. Patients with and without elasticity decrease after chemoradiotherapy comprised the internal anal sphincter sclerosis and non-sclerosis groups, respectively. The maximum resting pressure post-chemoradiotherapy was significantly high in the internal anal sphincter sclerosis group (63.0 mmHg vs. 47.0 mmHg), and a majority had a worsening Wexner score (60.0% vs. 18.2%) compared with that of the non-sclerosis group. Decreasing elasticity (internal anal sphincter sclerosis) correlated with a higher maximum resting pressure (r = 0.36); no correlation was observed between the degree of elasticity change and maximum squeeze pressure. Conclusion: Internal anal sphincter sclerosis due to chemoradiotherapy may correlate to anorectal dysfunction.
- Subjects
TOKYO Daigaku; ANUS; CHEMORADIOTHERAPY; ONCOLOGIC surgery; ELASTOGRAPHY; RECTAL cancer
- Publication
International Journal of Colorectal Disease, 2024, Vol 39, Issue 1, p1
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-024-04633-8