Effectiveness of biofeedback training among rectal cancer patients: a randomized controlled trial

Objective To evaluate the effect of biofeedback training on bowl function among rectal cancer patients with chemoradiotherapy and temporary enterostomy. Methods Using randomized controlled trial design, 109 rectal cancer patients were randomly divided into three groups, the first blank control group, the second group pelvic floor muscle exercise group, the third group biofeedback group. High resolution anorectal manometry was used for 6 longitudinal traces in 16 months. Data of bowel function were collected by Memorial Sloan Kettering Cancer Center (MSKCC) Bowel Function Instrument. Results The main effect of the change of five indicators, anal resting pressure, rectal resting pressure, maximum squeeze pressure, maximum squeeze time and high pressure zone, was time. The other four indicators, rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were (32.71±5.00) ml, (74.26±8.30) ml, (188.40±12.68) ml, (5.69±1.18) ml/kPa and (68.09±6.38). The rectal volume at first senory, rectal volume at sense of convenience, maximal tolerable rectal volume and rectal compliance, among patients of biofeedback group were significant higher than blank control group and pelvic floor muscle exercise group (F=3.589-26.826, P<0.05). Conclusion The biofeedback could significantly improve the sensory indicators of patients with middle and low rectal cancer. High-resolution anorectal manometry could effectively evaluate the effect of biofeedback training in patients with middle and low rectal cancer. Key words: Biofeedback training; Rectal neoplasms; Sphincter preservation operation; Colostomy; High resolution anorectal manometry; Bowel function