HIGH-RESOLUTION ANORECTAL MANOMETRY IN TESTING ANORECTAL FUNCTION AFTER COMBINATION TREATMENT FOR RECTAL CANCER

Abstract

The purpose of the study was to evaluate anorectal function with high-resolution anorectal manometry in patients receiving combination treatment for rectal cancer. Material and methods. We analyzed literature data (PubMed, Scopus, eLIBRARY databases) and our treatment outcomes in 50 rectal cancer patients receiving combination or surgical treatment at Rostov Research Institute of Oncology. Results. The mean anal resting pressure was 1.8 times lower, and the maximal anal squeeze pressure was 1.5 times lower in patients after combination treatment, compared to surgical treatment (p<0.05). 3 months after combination treatment with prolonged radiotherapy, contractile properties of the internal sphincter were decreased in 83.3%, of the external sphincter - in 26.7% of patients. Fatigue rate of external sphincter muscles was increased in 17 (56.7%) patients of this group. We observed a correlation between some anorectal manometry data and the LARS score: in both groups, patients with the maximal LARS score showed the lowest mean anal resting pressure, compared to patients with minimal and average LaRs scores (p<0.05). Conclusion. Due to negative effect of radiation therapy on the anorectal function, careful selection of patients who will benefit from radiation therapy is very important, as well as identification of patients with a high risk of radiation-induced functional problems and development of rehabilitation programs for patients treated for rectal cancer.