Assessment of patient experiences following total sacrectomy for primary malignant sacral tumors: A qualitative study

Abstract

Background and Objectives Few reports have investigated patient experiences following total en bloc sacrectomy. The aims of this study were to obtain a deeper understanding of patients’ personal experiences, needs, and satisfaction with the treatment to reveal areas in which perioperative and long‐term patient care can be improved. Methods A qualitative design was applied to examine patient experiences and supportive care needs. Patients treated between 2007 and 2017 were identified from our institutional database. Results A total of 28 survivors were interviewed (13 females, age 13‐75 years). Eight themes were identified: the effect of surgery on patients’ (a) daily lives, (b) social activities, (c) work or school activities, (d) and family lives; (e) acceptance of ostomy surgery; (f) need for guidance regarding long‐term rehabilitation; (g) satisfaction with the medical services provided in the hospital; and (h) satisfaction with the treatment outcomes. Conclusion Total en bloc sacrectomy can yield satisfactory oncological outcomes; however, the procedure is a life‐changing event for patients and their families. Physicians must provide long‐term support and guidance after surgery to enable patients to fully understand and cope with the changes in their lives.

Total sacrectomy with a combined antero-posterior surgical approach for malignant sacral tumours

“…Tomita proposed the use of total sacrectomy for the treatment of sacral tumours [11]. Although most patients have permanent neurological deficits after tumour resection, extensive/ adequate excision is the best treatment for sacral tumours to reduce the chance of local recurrence and prolong survival time [9,10,13]. The sacrococcygeal anatomical structure is complex and makes complete resection of the tumour difficult; furthermore, post-operative local recurrence rates are high [12].…”

“…This approach safely separates the rectum and blood vessels in the anterior sacral region, and the posterior incision is closed with a rectus flap [7,8]. However, total sacrectomy can destroy the continuity of the sacroiliac joint; hence, post-resection restoration of stress conduction and stability of the lumbosacral region directly determines the patient's postoperative function and quality of life [9,10]. This study retrospectively investigated the surgical indications, approaches, resection methods, and complications of total sacrectomy with a combined antero-posterior surgical approach in malignant sacral tumours.…”

Clinical manifestations, classification, and surgical management of sacral tumors and the need for personalized approach to sacrectomy

“…Other important considerations include patient and family education on home care management and counseling services for coping with functional losses, as well as referral for chronic pain management, sexual dysfunction, and physical or occupational rehabilitation. [ 38 ]…”