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

Area of Science:

• Gastroenterology
• Oncology
• Surgical Oncology

Background:

• Chemoradiotherapy is a standard treatment for rectal cancer.
• Anorectal function can be affected by chemoradiotherapy.
• Internal anal sphincter elasticity changes are not well understood post-treatment.

Purpose of the Study:

• To investigate the relationship between changes in internal anal sphincter elasticity and anorectal function after chemoradiotherapy.
• To quantify internal anal sphincter hardness using transanal ultrasonography and real-time tissue elastography.

Main Methods:

• Prospective cohort study of 27 rectal cancer patients.
• Transanal ultrasonography with real-time tissue elastography to measure internal anal sphincter elasticity before and after chemoradiotherapy.
• Assessed correlation between elasticity changes, maximum resting pressure, maximum squeeze pressure, and Wexner score.

Main Results:

• 59.3% of patients showed decreased elasticity (sclerosis) post-chemoradiotherapy.
• The internal anal sphincter sclerosis group had significantly higher maximum resting pressure (63.0 mmHg vs. 47.0 mmHg).
• Worsening Wexner scores were more common in the sclerosis group (60.0% vs. 18.2%).

Conclusions:

• Chemoradiotherapy-induced internal anal sphincter sclerosis may be linked to anorectal dysfunction.
• Decreased elasticity correlates with increased maximum resting pressure.
• Further research is needed to fully understand the impact on anorectal function.