PURPOSE: To assess pain management in patients post-sacrectomy, focusing on opioid use, and to identify the factors associated with postoperative pain. METHODS: Patients who underwent resection of locally recurrent rectal cancer (LRRC) with concomitant sacrectomy at one of two hospitals between 2007 and 2020 were reviewed retrospectively. We examined the use of opioids preoperatively and postoperatively. Patients were classified into high and low sacrectomy groups based on the sacral bone resection level passing through the S3 vertebra. RESULTS: Sixty-four patients were enrolled. Opioid use was significantly higher in the high sacrectomy group than in the low sacrectomy group at all times assessed: on postoperative days 7, 14, 30, 90, 180, and 365. Opioid use 3 months after locally recurrent rectal cancer surgery was significantly higher in patients with local re-recurrence of the tumor than in those without re-recurrence (p < 0.05), and the median morphine-equivalent opioid use 3 months postoperatively was significantly higher in the high sacrectomy group (30 vs. 0 mg/day; p < 0.05). CONCLUSIONS: Opioid use after concomitant sacrectomy for LRRC was higher in the high sacrectomy group. Prolonged postoperative pain or increasing pain was associated with local recurrence.
PURPOSE: To assess pain management in patients post-sacrectomy, focusing on opioid use, and to identify the factors associated with postoperative pain. METHODS: Patients who underwent resection of locally recurrent rectal cancer (LRRC) with concomitant sacrectomy at one of two hospitals between 2007 and 2020 were reviewed retrospectively. We examined the use of opioids preoperatively and postoperatively. Patients were classified into high and low sacrectomy groups based on the sacral bone resection level passing through the S3 vertebra. RESULTS: Sixty-four patients were enrolled. Opioid use was significantly higher in the high sacrectomy group than in the low sacrectomy group at all times assessed: on postoperative days 7, 14, 30, 90, 180, and 365. Opioid use 3 months after locally recurrent rectal cancer surgery was significantly higher in patients with local re-recurrence of the tumor than in those without re-recurrence (p < 0.05), and the median morphine-equivalent opioid use 3 months postoperatively was significantly higher in the high sacrectomy group (30 vs. 0 mg/day; p < 0.05). CONCLUSIONS: Opioid use after concomitant sacrectomy for LRRC was higher in the high sacrectomy group. Prolonged postoperative pain or increasing pain was associated with local recurrence.
Authors: Genevieve B Melton; Philip B Paty; Patrick J Boland; John H Healey; Salvatore G Savatta; Jorge E Casas-Ganem; José G Guillem; Martin R Weiser; Alfred M Cohen; Bruce D Minsky; W Douglas Wong; Larissa K Temple Journal: Dis Colon Rectum Date: 2006-08 Impact factor: 4.585
Authors: Nestor F Esnaola; Scott B Cantor; Margo L Johnson; Attiqa N Mirza; Alexander R Miller; Steven A Curley; Christopher H Crane; Charles S Cleeland; Nora A Janjan; John M Skibber Journal: J Clin Oncol Date: 2002-11-01 Impact factor: 44.544
Authors: Martin R Weiser; Ron G Landmann; W Douglas Wong; Jinru Shia; José G Guillem; Larissa K Temple; Bruce D Minsky; Alfred M Cohen; Philip B Paty Journal: Dis Colon Rectum Date: 2005-06 Impact factor: 4.585
Authors: Andrew R L Stevenson; Michael J Solomon; Christopher S B Brown; John W Lumley; Peter Hewett; Andrew D Clouston; Val J Gebski; Kate Wilson; Wendy Hague; John Simes Journal: Ann Surg Date: 2019-04 Impact factor: 12.969