The Price We Pay for Radical Curative Pelvic Exenterations: Prevalence and Management of Pain

Koh, Cherry; Liu, Hannah; Solomon, Michael J.; Johnstone, Charlotte

doi:10.1097/dcr.0000000000001013

Cited by 14 publications

(24 citation statements)

References 19 publications

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“…L5 and S1 are required for acceptable motor function and avoidance of an ipsilateral foot drop. Postoperative pain is also a significant problem for patients undergoing sacrectomy, with a subsequent impact on quality of life, irrespective of the sacrectomy level [ 42 , 43 ].…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Rogers

Jenkins

Malietzis

et al. 2021

JCM

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Treatment strategies for advanced or recurrent rectal cancer have evolved such that the ultimate surgical goal to achieve a cure is complete pathological clearance. To achieve this where the sacrum is involved, en bloc sacrectomy is the current standard of care. Sacral resection is technically challenging and has been described; however, the technique has yet to be streamlined across units. This comprehensive review aims to outline the surgical approach to en bloc sacrectomy for locally advanced or recurrent rectal cancer, with standardisation of the operative steps of the procedure and to discuss options that enhance the technique.

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Section: Postoperative Complicationsmentioning

confidence: 99%

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Rogers

Jenkins

Malietzis

et al. 2021

JCM

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“…Ten studies (47%) were judged to be at moderate risk of bias [2–5, 21, 26, 29, 30, 32, 35]. Another 10 studies (47%) were at serious risk of bias [19, 20, 22–24, 27, 28, 31, 33, 34]. One study, which was a conference abstract, was considered to have a critical risk of bias [25].…”

Section: Resultsmentioning

confidence: 99%

“…A summary of reported pain outcomes is presented in Table 2. Pain outcomes were reported using the Verbal Numerical Rating Scale (VNRS; n = 2 studies) [26, 28], Visual Analogue Scale (VAS; n = 1 study) [26], 36‐item Short Form Survey (SF‐36; n = 3 studies) [3, 21, 24], Brief Pain Inventory (BPI; n = 2 studies) [4, 20], European Organisation for the Research and Treatment of Cancer – Quality of Life Questionnaire (EORTC QLQ; n = 4 studies) [29, 30, 32, 35] Psychological Distress Inventory (PDI) and Mini‐Mental Adjustment to Cancer (Mini‐MAC; n = 1 study) [26] measures.…”

Section: Resultsmentioning

confidence: 99%

Pain, pain management and related outcomes following pelvic exenteration surgery: a systematic review

et al. 2023

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Aim Pelvic exenteration surgery can improve survival in people with advanced colorectal cancer. This systematic review aimed to review pain intensity and other outcomes, for example the management of pain, the relationship between pain and the extent of surgery and the impact of pain on short‐term outcomes. Method Electronic databases were searched from inception to 1 May 2021. We included interventional studies of adults with any indication for pelvic exenteration surgery that also reported pain outcomes. Risk of bias was assessed using ROBINS‐1. Results The search found 21 studies that reported pain following pelvic exenteration [n = 1317 patients, mean age 58.4 years (SD 4.8)]. Ten studies were judged to be at moderate risk of bias. Before pelvic exenteration, pain was reported by 19%–100% of patients. Five studies used validated measures of pain intensity. No study measured pain at all three time points in the surgical journey. The presence of pain before surgery predicted postoperative adverse pain outcomes, and pain is more likely to be experienced in those who require wider resections, including bone resection. Conclusion Considering that pain following pelvic exenteration is commonly described by patients, the literature suggests that this symptom is not being measured and therefore addressed.

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“…18,77 The themes identified were symptoms, sexual function, psychological impact, role and social functioning, future perspective and healthcare service utilisation and delivery. Nineteen (54.3%) of the studies identified in this review have been published since this work, [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] using a median of two PROMS, with the EORTC QLQ-CR29 and FACT-C most used. The EORTC QLQ-CR29 and FACT-C have also both demonstrated robust psychometric properties, including content validity, in patients with primary colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer

et al. 2023

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Background The availability of high-quality patient-reported outcome (PRO) data is crucial to guiding shared decision-making in the context of locally recurrent rectal cancer (LRRC), where potential treatment benefits must be balanced against the impact of both the disease and treatment on PROs, such as quality of life. This review aimed to identify the patient-reported outcome measures (PROMs) currently being reported in LRRC and to appraise the methodological quality of studies using these measures. Methods PubMed, Embase and CINAHL databases were searched, including studies published up until 14th September 2022. Studies in adults with LRRC reporting PROMS as a primary or secondary outcome measure were included. Data were extracted concerning the methodological quality of the reporting of PROMs using criteria informed by the CONSORT-PRO checklist and the psychometric properties of the PROMs identified using the COSMIN Risk of Bias checklist. Results Thirty-five studies including 1914 patients with LRRC were identified. None of the studies included in the review met all eleven criteria for the quality of reporting of PROMs. Seventeen PROMs and two clinician-reported outcome measures were identified, none of which have been validated for use in patients with LRRC. Conclusions None of the PROMs which are currently being used to report PROs in LRRC have been validated for use in this cohort of patients. Future studies in this disease area should focus on utilising PROMs that have undergone a robust development process including patients with LRRC, to produce data which is high quality, accurate and relevant.

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The Price We Pay for Radical Curative Pelvic Exenterations: Prevalence and Management of Pain

Cited by 14 publications

References 19 publications

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

Pain, pain management and related outcomes following pelvic exenteration surgery: a systematic review

Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer

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