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International Journal of Colorectal Disease

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Open Access 01-12-2024 | Rectal Cancer | RESEARCH

Evaluation of anorectal function using real-time tissue elastography before and after preoperative chemoradiotherapy

Authors: Akira Sakamoto, Kazuhito Sasaki, Hiroaki Nozawa, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Shinya Abe, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara

Published in: International Journal of Colorectal Disease | Issue 1/2024

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.

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Title: Evaluation of anorectal function using real-time tissue elastography before and after preoperative chemoradiotherapy
Authors: Akira Sakamoto
Kazuhito Sasaki
Hiroaki Nozawa
Koji Murono
Shigenobu Emoto
Yuichiro Yokoyama
Hiroyuki Matsuzaki
Yuzo Nagai
Shinya Abe
Takahide Shinagawa
Hirofumi Sonoda
Soichiro Ishihara
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Published in: International Journal of Colorectal Disease / Issue 1/2024
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-024-04633-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of anorectal function using real-time tissue elastography before and after preoperative chemoradiotherapy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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