Thoracoscopic splanchnicectomy for control of intractable pain due to advanced pancreatic cancer.
BACKGROUND
Severe upper abdominal pain is a dominant and distressing feature of advanced pancreatic cancer. This study was performed to evaluate pain intensity and to determine the ways in which pain may interfere with the common daily activities of patients with intractable pain before and after thoracoscopic splanchnicectomy.


METHODS
Twenty-six left-sided thoracoscopic splanchnicectomies were performed. To assess pain severity and the impact of pain, all patients completed a short questionnaire using the 0-10 Numeric Rating Scale. The Pain Management Index was used to describe and compare the adequacy of analgesic management. Patients were evaluated 1 day prior to operation and for 6 months after the procedure.


RESULTS
Pain was reduced significantly after the operation (p < 0.001), and all patients enjoyed consistent pain relief during the postoperative follow-up. The degree to which pain interfered with their daily function decreased significantly (p < 0.001) after surgery. The adequacy of the analgesic management improved, and none of the patients required opioids.


CONCLUSIONS
Unilateral left thoracoscopic splanchnicectomy is a simple, minimally invasive, effective, and safe procedure that can be recommended as the method of choice for the management of intractable upper abdominal pain due to advanced pancreatic cancer.
Leksowski
K
K
Department of Surgery, Military Clinical Hospital, 5 Powstańców Warszawy Street, 85-915 Bydgoszcz, Poland.
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology* / Q000601:surgery*; D010179:Pancreas / Q000294:innervation; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013153:Splanchnic Nerves / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome