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

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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.

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Acknowledgments

The authors would like to thank Helle Buch (Research nurse) for telephone interviewing the patients, Kenneth Andersen (MD) and colleagues for translating S-LANSS to Danish with permission from Mike Bennett, Ernst Eypasch (prof., Dr. med.) for permission to use the GIQLI instrument, and Birgitte Brandsborg (Ph.d, MD) for survey inspiration. We would further like to thank Josephine Rothman (BMSc) for double data entry and Jannie Laursen (Research nurse) and Eske Aasvang (Dr. med.) for expert evaluation of the survey instrument.

Grant support

The authors received no grants or external funding in connection to this study.

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Correspondence to Maja Jeppesen.

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Jeppesen, M., Tolstrup, MB. & Gögenur, I. Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction. World J Surg 40, 2091–2097 (2016). https://doi.org/10.1007/s00268-016-3616-9

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