Top

World Journal of Surgery

Published in:

01-09-2016 | Original Scientific Report

Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction

Authors: Maja Jeppesen, Mai-Britt Tolstrup, Ismail Gögenur

Published in: World Journal of Surgery | Issue 9/2016

Abstract

Background

Emergency laparotomy is a high-risk procedure regarding short-term outcomes; however, long-term outcomes are not well described. The aim of this study was to determine the frequency of chronic postoperative pain, pain-related functional impairment, and incisional hernias and to evaluate the gastrointestinal quality of life after emergency laparotomy due to small bowel obstruction.

Methods

This study was a questionnaire study, conducted at a major gastrointestinal-surgery department in a single tertiary university hospital in Denmark. Patients who had been through emergency laparotomy due to small bowel obstruction were included in the study. The extent of acute and chronic postoperative pain and the prevalence of incisional hernias were examined with specially designed questionnaires, while the pain quality was assed by the self-report version of the S-LANSS-questionnaire. Pain-related functional impairment and quality of life were measured using the AAS and the GIQLI questionnaire, respectively.

Results

A total of 90 patients returned the questionnaire (response rate 82 %). Nineteen patients (21 %) suffered from chronic postoperative pain. Seventeen patients (19 %) had pain-related functional impairment as a result of the surgery, and 17 patients (19 %) had an incisional hernia at follow-up. Patients with chronic postoperative pain had significantly lower gastrointestinal quality of life score compared with the remaining study population (109 (IQR 39) vs. 127 (IQR 19), P < 0.001).

Conclusions

Chronic postoperative pain is a common long-term complication after emergency laparotomy, and it is related to decreased quality of life. These results should be confirmed in prospective studies.

Macrae WA (2001) Chronic pain after surgery. Br J Anaesth 87:88–98CrossRefPubMed

Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367:1618–1625CrossRefPubMed

Perkins FM, Kehlet H (2000) Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology 93:1123–1133PubMed

Bruce J, Krukowski ZH (2006) Quality of life and chronic pain four years after gastrointestinal surgery. Dis Colon Rectum 49:1362–1370CrossRefPubMed

Gupta A, Gandhi K, Viscusi ER (2011) Persistent postsurgical pain after abdominal surgery. Tech Reg Anesth Pain Manag 15:140–146CrossRef

Brandsborg B, Nikolajsen L, Hansen CT et al (2007) Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology 106:1003–1012CrossRefPubMed

Saunders DI, Murray D, Pichel AC et al (2012) Variations in mortality after emergency laparotomy: the first report of the UK emergency laparotomy network. Br J Anaesth 109:368–375CrossRefPubMed

Al Temimi MH (2012) When is death inevitable after emergency laparotomy? Analysis of the american college of surgeons national surgical quality improvement program database. J Am Coll Surg 215:503–511CrossRefPubMed

Welch JP (1990) General consideration and mortality in bowel obstruction. Bowel obstruction: differential diagnosis and clinical management. Saunders, Philadelphia, pp 59–95

10.

Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol 5:649–655CrossRefPubMed

11.

Bennett MI, Smith BH, Torrance N et al (2005) The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain 6:149–158CrossRefPubMed

12.

McCarthy M Jr, Jonasson O, Chang CH et al (2005) Assessment of patient functional status after surgery. J Am Coll Surg 201:171–178CrossRefPubMed

13.

Eypasch E, Williams JI, Wood-Dauphinee S et al (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82:216–222CrossRefPubMed

14.

Barber MD, Janz N, Kenton K et al (2012) Validation of the surgical pain scales in women undergoing pelvic reconstructive surgery. Female Pelvic Med Reconstr Surg 18:198–204CrossRefPubMedPubMedCentral

15.

Aasvang EK, Gmaehle E, Hansen JB et al (2010) Predictive risk factors for persistent postherniotomy pain. Anesthesiology 112:957–969CrossRefPubMed

16.

Drennan J (2003) Cognitive interviewing: verbal data in the design and pretesting of questionnaires. J Adv Nurs 42:57–63CrossRefPubMed

17.

Fevang BT, Fevang J, Lie SA et al (2004) Long-term prognosis after operation for adhesive small bowel obstruction. Ann Surg 240:193–201CrossRefPubMedPubMedCentral

18.

Szentkirályi A, Madarász CZ, Novák M (2009) Sleep disorders: impact on daytime functioning and quality of life. Expert Rev Pharmacoecon Outcomes Res 9:49–64CrossRefPubMed

19.

Ten Broek RP, Issa Y, van Santbrink EJ et al (2013) Burden of adhesions in abdominal and pelvic surgery: systematic review and meta-analysis. BMJ 347:f5588CrossRefPubMedPubMedCentral

20.

Gerner-Rasmussen J, Burcharth J, Gögenur I (2015) The efficacy of adhesiolysis on chronic abdominal pain: a systematic review. Langenbecks Arch Surg 400:567–576CrossRefPubMed

21.

Katz J, Jackson M, Kavanagh BP et al (1996) Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain 12:50–55CrossRefPubMed

22.

Callesen T, Bech K, Kehlet H (1999) Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528–1531CrossRefPubMed

23.

Margenthaler JA, Longo WE, Virgo KS et al (2006) risk factors for adverse outcomes following surgery for small bowel obstruction. Ann Surg 243:456–464CrossRefPubMedPubMedCentral

Title: Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction
Authors: Maja Jeppesen
Mai-Britt Tolstrup
Ismail Gögenur
Publication date: 01-09-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 9/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3616-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2016

A Positive Node on Ultrasound-Guided Fine Needle Aspiration Predicts Higher Nodal Burden Than a Positive Sentinel Lymph Node Biopsy in Breast Carcinoma

Prospective Validation of Optimal Drain Management “The 3 × 3 Rule” after Liver Resection

Distal Pancreatectomy with En Bloc Resection of the Celiac Axis with Preservation or Reconstruction of the Left Gastric Artery in Patients with Pancreatic Body Cancer

Comparison of Surgical Outcomes Between Radical Antegrade Modular Pancreatosplenectomy (RAMPS) and Standard Retrograde Pancreatosplenectomy (SPRS) for Left-Sided Pancreatic Cancer

Non-Obstetric Surgical Care at Three Rural District Hospitals in Rwanda: More Human Capacity and Surgical Equipment May Increase Operative Care

The Cost of Intramedullary Nailing for Femoral Shaft Fractures in Dar es Salaam, Tanzania