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Quality of Life and Chronic Pain Four Years After Gastrointestinal Surgery

  • Published:
Diseases of the Colon & Rectum

Purpose

Little is known about the prevalence of chronic postsurgical pain after gastrointestinal surgery. This study was designed to assess the prevalence of chronic pain andquality of life in a cohort of patients who underwent surgery for benign and malignant gastrointestinal disease.

Methods

A prospective cohort design was used to assess quality of life and morbidity at four years postoperatively in435 patients who had upper, hepatopancreaticobiliary, small-bowel, and/or colorectal anastomotic surgery in 1999 at one regional center in Northeast Scotland. Chronic pain and quality of life were assessed by postal survey using the European Organization for Research and Treatment of Cancer Quality of Life-C30 questionnaire and McGill Pain Questionnaire.

Results

Of the 435 patients recruited in 1999, 135 (31 percent) had died by censor date in 2003. There was a 74 percent (n = 202) response rate from surviving patients eligible for follow-up. Prevalence of chronic pain at four years postoperatively was 18 percent (95 percent confidence interval, 13–23 percent). Pain was predominantly neuropathic in character; a subgroup reported moderate-to-severe pain. Risk factors for chronic postsurgical pain included female gender, younger age, and surgery for benign disease. Compared with those who were pain-free at follow-up, patients with chronic pain had poorer functioning, poorer global quality of life, and more severe symptoms, independent of age, gender, and cancer status.

Conclusions

The prevalence of chronic pain after laparotomy for gastrointestinal malignancy and nonmalignant conditions at four years after surgery was 18 percent. These patients had significantly poorer quality of life scores independent of age, gender, and cancer status.

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Acknowledgment

The authors thank the patients who participated in this study. Thanks to Moira Turner for data collection.

Author information

Authors and Affiliations

  1. Department of Public Health, University of Aberdeen, Medical School, Aberdeen, United Kingdom

    Julie Bruce Ph.D.

  2. Ward 49, Aberdeen Royal Infirmary, Aberdeen, United Kingdom

    Zygmunt H. Krukowski F.R.C.S.

  3. MRC Research Fellow in Epidemiology, Department of Public Health, University of Aberdeen, Polwarth Building, Medical School, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom

    Julie Bruce Ph.D.

Authors
  1. Julie Bruce Ph.D.
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  2. Zygmunt H. Krukowski F.R.C.S.
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Corresponding author

Correspondence to Julie Bruce Ph.D..

Additional information

Supported by the Departments of Surgery and Public Health at the University of Aberdeen. Dr. Julie Bruce is funded by the Medical Research Council (MRC) Special Training Fellowship in Health Services & Health of the Public Research.

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Bruce, J., Krukowski, Z.H. Quality of Life and Chronic Pain Four Years After Gastrointestinal Surgery. Dis Colon Rectum 49, 1362–1370 (2006). https://doi.org/10.1007/s10350-006-0575-5

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  • DOI: https://doi.org/10.1007/s10350-006-0575-5

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