Ménière’s disease (MD) is a multifactorial disorder with typical symptoms of recurrent vertigo, tinnitus, fluctuating hearing loss, and sensations of ear fullness. This disease greatly reduces the quality of life for patients. Unfortunately, it is difficult to diagnose and predictthe prognosis using only diagnostic methods, including audiometry. Therefore, since the mid-2000s, various efforts have been made to directly identify endolymphatic hydrops (EH), a histologic hallmark of MD, through magnetic resonance imaging (MRI) of the inner ear. Various studies have revealed significant correlation among degree of EH on inner ear MRI, patient symptoms, and test results. Although there are some limitations, inner ear MRI is expected to be widely used for differential diagnosis of MD, recurrent low-frequency hearing loss, non-specific vertigo, and vestibular migraine. In addition, as an automated analysis system of EH using the convolutional neural network algorithm has been developed,the usefulness of inner ear MRI is increasing. This algorithm can generate results that are highly consistent with those generated by manual calculation and can do so more quickly. Although there are some limitations to be overcome, inner ear MRI is expected to be widely used for differential diagnosis of various EH-related diseases in the not-too-distantfuture.
{"title":"The usefulness of inner ear magnetic resonance imaging in patient with Ménière’s disease: A narrative review","authors":"Y. Cho, B. Song, Baek Hwan Cho, W. Chung","doi":"10.23838/pfm.2022.00051","DOIUrl":"https://doi.org/10.23838/pfm.2022.00051","url":null,"abstract":"Ménière’s disease (MD) is a multifactorial disorder with typical symptoms of recurrent vertigo, tinnitus, fluctuating hearing loss, and sensations of ear fullness. This disease greatly reduces the quality of life for patients. Unfortunately, it is difficult to diagnose and predictthe prognosis using only diagnostic methods, including audiometry. Therefore, since the mid-2000s, various efforts have been made to directly identify endolymphatic hydrops (EH), a histologic hallmark of MD, through magnetic resonance imaging (MRI) of the inner ear. Various studies have revealed significant correlation among degree of EH on inner ear MRI, patient symptoms, and test results. Although there are some limitations, inner ear MRI is expected to be widely used for differential diagnosis of MD, recurrent low-frequency hearing loss, non-specific vertigo, and vestibular migraine. In addition, as an automated analysis system of EH using the convolutional neural network algorithm has been developed,the usefulness of inner ear MRI is increasing. This algorithm can generate results that are highly consistent with those generated by manual calculation and can do so more quickly. Although there are some limitations to be overcome, inner ear MRI is expected to be widely used for differential diagnosis of various EH-related diseases in the not-too-distantfuture.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44998878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the Precision and Future Medicine editors to our ad hoc reviewers","authors":"Oh Young Bang","doi":"10.23838/pfm.2022.00016","DOIUrl":"https://doi.org/10.23838/pfm.2022.00016","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44041465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lung cancer is the leading cause of cancer-related deaths worldwide, and imaging techniques such as chest radiography, computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) play an important role in its diagnosis, staging, treatment planning, post-operative surveillance, and treatment response evaluation. Pulmonary MRI can non-invasively visualize structural and functional abnormalities in the lungs without using ionizing radiation, although it has been suggested that it has less clinical utility than chest radiography, CT, and PET/CT for thoracic diseases, especially lung diseases. With recent advances related to MRI pulse sequences, pulmonary MRI has become practicable in an expanding number of clinical situations. This review article focuses on recent advances in MRI and discusses its clinical applications in the detection, diagnosis, staging, pre-operative evaluation, post-operative surveillance, and treatment response evaluation of lung cancer.
{"title":"Magnetic resonance imaging for lung cancer: a state-of-the-art review","authors":"S. Bak, C. Kim, C. Kim, Y. Ohno, Ho Yun Lee","doi":"10.23838/pfm.2021.00170","DOIUrl":"https://doi.org/10.23838/pfm.2021.00170","url":null,"abstract":"Lung cancer is the leading cause of cancer-related deaths worldwide, and imaging techniques such as chest radiography, computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) play an important role in its diagnosis, staging, treatment planning, post-operative surveillance, and treatment response evaluation. Pulmonary MRI can non-invasively visualize structural and functional abnormalities in the lungs without using ionizing radiation, although it has been suggested that it has less clinical utility than chest radiography, CT, and PET/CT for thoracic diseases, especially lung diseases. With recent advances related to MRI pulse sequences, pulmonary MRI has become practicable in an expanding number of clinical situations. This review article focuses on recent advances in MRI and discusses its clinical applications in the detection, diagnosis, staging, pre-operative evaluation, post-operative surveillance, and treatment response evaluation of lung cancer.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42582186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Migraine is a very common brain disorder that causes throbbing headaches of moderate-to-severe intensity that are associated with a variety of symptoms like nausea, vomiting, multisensory hypersensitivity, dizziness, fatigue, cognitive dysfunction, and sleep problems, among others. The diverse symptomatology of migraine hints at the complexity of the disease and implies the involvement of multiple nervous system components, including the somatosensory, executive, autonomic, endocrine, and arousal networks. The major pathophysiologic mechanisms responsible for migraine attacks have been identified over the past several decades, and the elucidation of these mechanisms has brought about remarkable advances in therapeutic strategies, including the creation of anti-calcitonin gene-related peptide therapeutics—the newest addition to the list of anti-migraine therapies. However, current knowledge on the pathophysiologic mechanisms of migraine remains incomplete and treatments are only partially effective, with the involvement of the limbic system being less often recognized and symptoms related to the limbic system being undertreated. This article reviews recent advances in understanding the pathophysiologic roles of the limbic system in migraine and how the limbic system contributes to clinical features observed in migraine.
{"title":"The under-recognized but essential role of the limbic system in the migraine brain: a narrative review","authors":"C. Chung, T. Schwedt","doi":"10.23838/pfm.2020.00142","DOIUrl":"https://doi.org/10.23838/pfm.2020.00142","url":null,"abstract":"Migraine is a very common brain disorder that causes throbbing headaches of moderate-to-severe intensity that are associated with a variety of symptoms like nausea, vomiting, multisensory hypersensitivity, dizziness, fatigue, cognitive dysfunction, and sleep problems, among others. The diverse symptomatology of migraine hints at the complexity of the disease and implies the involvement of multiple nervous system components, including the somatosensory, executive, autonomic, endocrine, and arousal networks. The major pathophysiologic mechanisms responsible for migraine attacks have been identified over the past several decades, and the elucidation of these mechanisms has brought about remarkable advances in therapeutic strategies, including the creation of anti-calcitonin gene-related peptide therapeutics—the newest addition to the list of anti-migraine therapies. However, current knowledge on the pathophysiologic mechanisms of migraine remains incomplete and treatments are only partially effective, with the involvement of the limbic system being less often recognized and symptoms related to the limbic system being undertreated. This article reviews recent advances in understanding the pathophysiologic roles of the limbic system in migraine and how the limbic system contributes to clinical features observed in migraine.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41661647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health screening is an important component of health promotion programs, and run trials have promoted general health screening targeting the prevention and early man agent of common chronic diseases. In Korea, a General Health Screening Program (GHSP) gan with workers in the 1950s and continuously expanded its target population, And currently includes the adult population. The main target diseases are cerebro - and cardiovascular diseases, including hypertensions, diabetes Mellitus, dyslipidemia, obesity, and related health behaviors. Other target conditions include other diseases (e.g., animia, live diseases, visual/auditor improvement), mental health (e.g., depression)), The National Health Information Database, including GHSP information, is now extensively used in clinical and public health research. The participation rate is currently 70% to 80%, but varies according to age, disability, And the socio-economic status. There is a need for a more systematic evaluation of the screening items, reducing dispersion gaps in segmentation, and linking GHSP to actual health promotion
{"title":"National General Health Screening Program in Korea: history, current status, and future direction: A scoping review","authors":"D. Shin, Juhee Cho, Jae-Hyun Park, B. Cho","doi":"10.23838/pfm.2021.00135","DOIUrl":"https://doi.org/10.23838/pfm.2021.00135","url":null,"abstract":"Health\u0007screening\u0007is\u0007an\u0007important\u0007component\u0007of\u0007health\u0007promotion\u0007programs,\u0007and\u0007coun-tries\u0007have\u0007promoted\u0007general\u0007health\u0007screening\u0007targeting\u0007the\u0007prevention\u0007and\u0007early\u0007man- agement\u0007of\u0007common\u0007chronic\u0007diseases.\u0007In\u0007Korea,\u0007a\u0007General\u0007Health\u0007Screening\u0007Program\u0007 (GHSP)\u0007began\u0007with\u0007workers\u0007in\u0007the\u00071950s\u0007and\u0007continuously\u0007expanded\u0007its\u0007target\u0007popula-tion,\u0007and\u0007currently\u0007includes\u0007the\u0007adult\u0007population.\u0007The\u0007main\u0007target\u0007diseases\u0007are\u0007cerebro-\u0007 and\u0007cardiovascular\u0007diseases,\u0007including\u0007hypertension,\u0007diabetes\u0007mellitus,\u0007dyslipidemia,\u0007 obesity,\u0007and\u0007related\u0007health\u0007behaviors.\u0007Other\u0007target\u0007conditions\u0007include\u0007other\u0007diseases\u0007 (e.g.,\u0007anemia,\u0007liver\u0007disease,\u0007visual/auditory\u0007impairment),\u0007mental\u0007health\u0007(e.g.,\u0007depres-sion),\u0007and\u0007geriatric\u0007disease\u0007and\u0007function\u0007(osteoporosis,\u0007dementia,\u0007risk\u0007of\u0007fall,\u0007etc.).\u0007The\u0007 National\u0007Health\u0007Information\u0007Database,\u0007including\u0007GHSP\u0007information,\u0007is\u0007now\u0007extensively\u0007 used\u0007in\u0007clinical\u0007and\u0007public\u0007health\u0007research.\u0007The\u0007participation\u0007rate\u0007is\u0007currently\u000770%\u0007to\u0007 80%,\u0007but\u0007varies\u0007according\u0007to\u0007age,\u0007disability,\u0007and\u0007the\u0007socioeconomic\u0007status.\u0007There\u0007is\u0007a\u0007 need\u0007for\u0007a\u0007more\u0007systematic\u0007evaluation\u0007of\u0007the\u0007screening\u0007items,\u0007reducing\u0007disparity\u0007gaps\u0007 in\u0007participation,\u0007and\u0007linking\u0007GHSP\u0007to\u0007actual\u0007health\u0007promotion.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46986770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Atrial fibrillation (AF), the most common among cardiac arrhythmias, is associated with significant morbidity and mortality. For its diagnosis, documentation of the electrocardiographic tracing is required. The use of eletrocardiogram has been established as a valuable noninvasive diagnostic tool, and the interpretation of electrocardiographic records using deep learning models has attracted significant attention in recent years. Relying on signal-to-image and transfer learning approaches, this study is aimed at the development of a deep neural network for classifying binary electrocardiographic records according to their rhythm, i.e., normal or AF.Methods: Electrocardiographic records labeled as normal (n = 917) or AF (n = 1,097) from the China Physiological Signal Challenge 2018 were collected and used to generate images, which were split into training and test sets and used as inputs to a dense convolutional neural network (DCNN). For the training, transfer learning with a fine tuning of all layers was applied. For a performance evaluation of the test set, the accuracy, sensitivity, specificity, F1-score, and area under the curve (AUC) were used as metrics.Results: For the test set, the proposed model achieved an accuracy of 99.34%, sensitivity of 98.85%, specificity of 100.00%, F1-score, of 99.42%, and AUC of 0.99.Conclusion: To validate the methodology, as well as apply it to the multilabel classification of arrhythmia, it is important that further studies adopting this approach be conducted for the detection of AF in larger volumes of data.
{"title":"Automated atrial fibrillation recognition in 12- lead electrocardiographic records: a signal to image and transfer learning approach: A case-control accuracy study","authors":"Elena Caires Silveira","doi":"10.23838/pfm.2021.00058","DOIUrl":"https://doi.org/10.23838/pfm.2021.00058","url":null,"abstract":"Purpose: Atrial fibrillation (AF), the most common among cardiac arrhythmias, is associated with significant morbidity and mortality. For its diagnosis, documentation of the electrocardiographic tracing is required. The use of eletrocardiogram has been established as a valuable noninvasive diagnostic tool, and the interpretation of electrocardiographic records using deep learning models has attracted significant attention in recent years. Relying on signal-to-image and transfer learning approaches, this study is aimed at the development of a deep neural network for classifying binary electrocardiographic records according to their rhythm, i.e., normal or AF.Methods: Electrocardiographic records labeled as normal (n = 917) or AF (n = 1,097) from the China Physiological Signal Challenge 2018 were collected and used to generate images, which were split into training and test sets and used as inputs to a dense convolutional neural network (DCNN). For the training, transfer learning with a fine tuning of all layers was applied. For a performance evaluation of the test set, the accuracy, sensitivity, specificity, F1-score, and area under the curve (AUC) were used as metrics.Results: For the test set, the proposed model achieved an accuracy of 99.34%, sensitivity of 98.85%, specificity of 100.00%, F1-score, of 99.42%, and AUC of 0.99.Conclusion: To validate the methodology, as well as apply it to the multilabel classification of arrhythmia, it is important that further studies adopting this approach be conducted for the detection of AF in larger volumes of data.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44412026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease A narrative review","authors":"Ji-Young Chang, J. Cheon","doi":"10.23838/pfm.2021.00128","DOIUrl":"https://doi.org/10.23838/pfm.2021.00128","url":null,"abstract":"","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45293712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Son, I. Lee, Sung Hwan Cho, B. Park, H. S. Kim, S. B. Park, H. W. Kim, Sang-Bo Oh, Tae Un Kim, D. Shin
The early rectal cancer (ERC) has increased with the national cancer screening project for early detection of colorectal cancer. The gold standard treatment for low rectal cancer is low anterior resection (LAR) based on total mesorectal excision. However, radical resection results in a high mortality and complication rate, and the deterioration of quality of life due to LAR syndrome, genitourinary dysfunction, and possible permanent stoma. Local excision with chemoradiation therapy could be one of the alternative therapeutic strategies for the organ preservation and a cure of cancer. To decide the treat-ment strategies, it is important to establish sophisticated indications that can maximize the therapeutic effect. ERC has heterogeneous pathological features, including aggressive behavior and occult lymph node metastasis, with different responses to chemora-diotherapy. Therefore, radiologic, endoscopic and pathologic evaluation to predict the risk of lymph node metastasis and local recurrence has been evolving to determine the optimal treatment strategy in the patient-tailored medicine. Recently, the long-term outcomes of prospective randomized clinical trials provide new hope for organ preservation in patients with ERC. In this paper, we aim to review various risk factors related to local recurrence and discuss the optimal treatment strategy for ERC
{"title":"Multidisciplinary treatment strategy for early rectal cancer A review","authors":"G. Son, I. Lee, Sung Hwan Cho, B. Park, H. S. Kim, S. B. Park, H. W. Kim, Sang-Bo Oh, Tae Un Kim, D. Shin","doi":"10.23838/pfm.2021.00163","DOIUrl":"https://doi.org/10.23838/pfm.2021.00163","url":null,"abstract":"The early rectal cancer (ERC) has increased with the national cancer screening project for early detection of colorectal cancer. The gold standard treatment for low rectal cancer is low anterior resection (LAR) based on total mesorectal excision. However, radical resection results in a high mortality and complication rate, and the deterioration of quality of life due to LAR syndrome, genitourinary dysfunction, and possible permanent stoma. Local excision with chemoradiation therapy could be one of the alternative therapeutic strategies for the organ preservation and a cure of cancer. To decide the treat-ment strategies, it is important to establish sophisticated indications that can maximize the therapeutic effect. ERC has heterogeneous pathological features, including aggressive behavior and occult lymph node metastasis, with different responses to chemora-diotherapy. Therefore, radiologic, endoscopic and pathologic evaluation to predict the risk of lymph node metastasis and local recurrence has been evolving to determine the optimal treatment strategy in the patient-tailored medicine. Recently, the long-term outcomes of prospective randomized clinical trials provide new hope for organ preservation in patients with ERC. In this paper, we aim to review various risk factors related to local recurrence and discuss the optimal treatment strategy for ERC","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46768831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Currently, the world is facing the coronavirus disease 2019 (COVID-19) pandemic. With this, an emerging infectious disease pandemic in the absence of effective antiviral agents and vaccines for a novel virus is no different from the 1918 influenza pandemic, which became a great disaster for humankind. We also experienced a global lockdown with a stringent implementation of social distancing, which is a first for mankind living in the present day, and has led to enormous economic damage and restrictions on individual freedom. The microorganism that will cause the next pandemic may be a highly fatal avian influenza virus, another coronavirus, or a completely different microorganism. This COVID-19 pandemic is an enormous lesson for humankind and is tantamount to a vaccine in preparation for the next pandemic. Important and urgent undertakings were given to each country in terms of complementing laws and regulations for a stronger and more resilient healthcare system, such as investment in research and development for new rapid diagnostic technologies, vaccines, new therapeutic agents, among others.
{"title":"Responses against infectious disease pandemics: a narrative review on COVID-19 A narrative review","authors":"D. Chung","doi":"10.23838/pfm.2021.00156","DOIUrl":"https://doi.org/10.23838/pfm.2021.00156","url":null,"abstract":"Currently, the world is facing the coronavirus disease 2019 (COVID-19) pandemic. With this, an emerging infectious disease pandemic in the absence of effective antiviral agents and vaccines for a novel virus is no different from the 1918 influenza pandemic, which became a great disaster for humankind. We also experienced a global lockdown with a stringent implementation of social distancing, which is a first for mankind living in the present day, and has led to enormous economic damage and restrictions on individual freedom. The microorganism that will cause the next pandemic may be a highly fatal avian influenza virus, another coronavirus, or a completely different microorganism. This COVID-19 pandemic is an enormous lesson for humankind and is tantamount to a vaccine in preparation for the next pandemic. Important and urgent undertakings were given to each country in terms of complementing laws and regulations for a stronger and more resilient healthcare system, such as investment in research and development for new rapid diagnostic technologies, vaccines, new therapeutic agents, among others.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42171777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sphincter preservation and organ restoration during rectal cancer surgery avoids permanent stoma creation and diminishes psychosocial damages. However, decreased rectal volumes and sphincter dysfunction—including pelvic nerve damage—results in low anterior resection syndrome, as well as urinary and sexual dysfunction after rectal resection. Bowel habit changes such as fecal incontinence, fecal urgency, frequent bowel movements, clustered stools, and difficulties in bowel emptying can be treated using medications, pelvic floor rehabilitation, sacral neuromodulation, or neorectal reservoir reconstruction. Pelvic nerve damage resulting from superior and inferior hypogastric plexi during sphincter-preserving rectal cancer surgery can induce urologic and sexual dysfunctions. Preoperative voiding difficulty, perioperative blood loss, and autonomic nerve injury are considered independent risk factors for postoperative urinary dysfunction. Retrograde ejaculation and erectile dysfunction, female dyspareunia, and vaginal dryness are manifestations of sexual dysfunction resulting from autonomic nerve injury during rectal cancer surgery. Multifactorial causes for functional outcomes after sphincter-preserving surgeries are considered to improve patient’s quality of life with acceptable oncologic outcomes in the treatment of rectal cancer patients.
{"title":"Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer A review","authors":"E. Park, S. Baik","doi":"10.23838/pfm.2021.00142","DOIUrl":"https://doi.org/10.23838/pfm.2021.00142","url":null,"abstract":"Sphincter preservation and organ restoration during rectal cancer surgery avoids permanent stoma creation and diminishes psychosocial damages. However, decreased rectal volumes and sphincter dysfunction—including pelvic nerve damage—results in low anterior resection syndrome, as well as urinary and sexual dysfunction after rectal resection. Bowel habit changes such as fecal incontinence, fecal urgency, frequent bowel movements, clustered stools, and difficulties in bowel emptying can be treated using medications, pelvic floor rehabilitation, sacral neuromodulation, or neorectal reservoir reconstruction. Pelvic nerve damage resulting from superior and inferior hypogastric plexi during sphincter-preserving rectal cancer surgery can induce urologic and sexual dysfunctions. Preoperative voiding difficulty, perioperative blood loss, and autonomic nerve injury are considered independent risk factors for postoperative urinary dysfunction. Retrograde ejaculation and erectile dysfunction, female dyspareunia, and vaginal dryness are manifestations of sexual dysfunction resulting from autonomic nerve injury during rectal cancer surgery. Multifactorial causes for functional outcomes after sphincter-preserving surgeries are considered to improve patient’s quality of life with acceptable oncologic outcomes in the treatment of rectal cancer patients.","PeriodicalId":42462,"journal":{"name":"Precision and Future Medicine","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46126680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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