Anorectal Disease: Current Challenges in Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (10 May 2024) | Viewed by 2536

Special Issue Editor


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Guest Editor
1. Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
2. Department of Medical Neurobiology, The Hebrew University of Jerusalem, Jerusalem, Israel
Interests: anorectal manometry; anorectal biofeedback; fecal incontinence; evacuation disorders; irritable bowel syndrome; anorectal pain; anorectal physiology

Special Issue Information

Dear Colleagues,

Anorectal disease, whether stemming from anatomical/organic or functional causes, can lead to significant symptoms and reduced quality of life for patients. These symptoms may manifest as fecal incontinence resulting from sphincter injury, anorectal radiation, trauma, or post-obstetric factors; obstructed defecation symptoms caused by prolapse, dyssynergia, or large rectocele; and anal pain arising from anal fissure, abscess, or functional pain. The diagnostic pathway, ancillary testing, and treatment options can vary depending on physician specialty and local expertise. While surgery can offer improvement for some symptoms, it may result in unsuccessful outcomes, especially when performed for the wrong indication. Lastly, anorectal disease should be addressed within the context of pelvic floor disorders, considering associated urinary symptoms and, in female patients, gynecological dysfunction.

This Special Issue aims to primarily focus on the current challenges associated with diagnosing and treating anorectal disease. We particularly encourage the submission of original research articles that adopt interdisciplinary approaches to examining either organic or functional anorectal symptoms. Additionally, we welcome the submission of high-interest review articles on this topic.

Dr. Yoav Mazor
Guest Editor

Manuscript Submission Information

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Keywords

  • anorectal disease
  • fecal incontinence
  • obstructed defecation
  • anal pain
  • pelvic floor disorders
  • interdisciplinary approaches
  • quality of life

Published Papers (2 papers)

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Research

18 pages, 2179 KiB  
Article
Performance and Dimensionality of Pretreatment MRI Radiomics in Rectal Carcinoma Chemoradiotherapy Prediction
by Mladen Marinkovic, Suzana Stojanovic-Rundic, Aleksandra Stanojevic, Aleksandar Tomasevic, Radmila Jankovic, Jerome Zoidakis, Sergi Castellví-Bel, Remond J. A. Fijneman, Milena Cavic and Marko Radulovic
J. Clin. Med. 2024, 13(2), 421; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13020421 - 12 Jan 2024
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Abstract
(1) Background: This study aimed to develop a machine learning model based on radiomics of pretreatment magnetic resonance imaging (MRI) 3D T2W contrast sequence scans combined with clinical parameters (CP) to predict neoadjuvant chemoradiotherapy (nCRT) response in patients with locally advanced rectal carcinoma [...] Read more.
(1) Background: This study aimed to develop a machine learning model based on radiomics of pretreatment magnetic resonance imaging (MRI) 3D T2W contrast sequence scans combined with clinical parameters (CP) to predict neoadjuvant chemoradiotherapy (nCRT) response in patients with locally advanced rectal carcinoma (LARC). The study also assessed the impact of radiomics dimensionality on predictive performance. (2) Methods: Seventy-five patients were prospectively enrolled with clinicopathologically confirmed LARC and nCRT before surgery. Tumor properties were assessed by calculating 2141 radiomics features. Least absolute shrinkage selection operator (LASSO) and multivariate regression were used for feature selection. (3) Results: Two predictive models were constructed, one starting from 72 CP and 107 radiomics features, and the other from 72 CP and 1862 radiomics features. The models revealed moderately advantageous impact of increased dimensionality, with their predictive respective AUCs of 0.86 and 0.90 in the entire cohort and 0.84 within validation folds. Both models outperformed the CP-only model (AUC = 0.80) which served as the benchmark for predictive performance without radiomics. (4) Conclusions: Predictive models developed in this study combining pretreatment MRI radiomics and clinicopathological features may potentially provide a routine clinical predictor of chemoradiotherapy responders, enabling clinicians to personalize treatment strategies for rectal carcinoma. Full article
(This article belongs to the Special Issue Anorectal Disease: Current Challenges in Diagnosis and Treatment)
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13 pages, 1571 KiB  
Article
Assessment of Quality of Life in Patients with Chronic Anal Fissures: A 1-Year Follow-Up Study before and after Botulinum Toxin (Botox) Injection
by Sonia-Roxana Burtic, Luca Castiglione, Marius Murariu, Ovidiu Rosca, Catalin Dumitru and Octavian Neagoe
J. Clin. Med. 2024, 13(2), 316; https://doi.org/10.3390/jcm13020316 - 5 Jan 2024
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Abstract
This longitudinal study aimed to assess the quality of life in patients with anal fissures treated with botulinum toxin (Botox) injections over a one-year period. The study hypothesized that Botox injections would significantly improve quality of life and that these improvements would be [...] Read more.
This longitudinal study aimed to assess the quality of life in patients with anal fissures treated with botulinum toxin (Botox) injections over a one-year period. The study hypothesized that Botox injections would significantly improve quality of life and that these improvements would be sustained over a year. Conducted as a cross-sectional study, it assessed adults diagnosed with chronic anal fissures unresponsive to conventional treatments. Participants received 25 U of Botox in two sessions and their quality of life was assessed using the WHOQOL-BREF, COPE-60, Hospital Anxiety and Depression Scale (HADS), and SF-36 surveys. Data were collected at baseline six months and one year post-treatment. The study involved 113 patients, with a mean age of 38.1 years. Significant improvements were observed in the WHOQOL-BREF scores across all domains from baseline to 12 months (physical domain: 49.4 ± 10.5 to 70.2 ± 10.6, p < 0.001; mental domain: 34.8 ± 11.2 to 61.9 ± 11.5, p < 0.001). SF-36 scores also showed significant enhancements in physical and mental health components (physical: 44.3 ± 7.5 to 56.9 ± 5.9, p < 0.001; mental: 41.1 ± 7.2 to 54.4 ± 6.3, p < 0.001). Additionally, significant improvements were noted in patient perception on quality of life from the perspective of various aspects including physical discomfort, pain management, and mood and emotional well-being. The study demonstrated that Botox injections significantly improved the quality of life in patients with chronic anal fissures, with sustained benefits observed over a year. These findings suggest Botox as an effective treatment modality for enhancing life quality in patients with this condition, highlighting the potential for broader applications in managing chronic anal fissures. Full article
(This article belongs to the Special Issue Anorectal Disease: Current Challenges in Diagnosis and Treatment)
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