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Effect of neoadjuvant chemoradiation on postoperative fecal continence and anal sphincter function in rectal cancer patients.

Abstract：

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.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Pietsch AP,Fietkau R,Klautke G,Foitzik T,Klar E

doi

10.1007/s00384-007-0322-y

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

1311-7

issue

11

eissn

0179-1958

issn

1432-1262

journal_volume

22

pub_type

临床试验,杂志文章

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