title: Persistent postsurgical pain.
abstract: OBJECTIVE
  Persistent postsurgical pain (PPP) is an important cause of pain morbidity following surgery for almost any cause, but there is a greater evidence base for pain after cancer surgery. Historically, both patients and practitioners have struggled to recognize and accept this growing problem. This review will seek to highlight the awareness of this increasing epidemic and will discuss evidence base for diagnosis, risk factors and current strategies for prevention and treatment, especially after cancer surgery.
  
  
  RESULTS
  Given the potential size of the problems of PPP, there is a relative paucity of recent data, especially as regards effective treatments. The review will synthesize current and existing evidence to give a balanced up-to-date view. There is a clear need for more high-quality randomized trials.
  
  
  CONCLUSIONS
  An estimated 40,000 patients in the UK will develop PPP, of whom at least 5-10% will have severe pain. Lack of clear definition and lack of awareness have been barriers to diagnosis and access to treatment. Several risk factors associated with PPP have been identified and reduction of these factors may prevent its development. At present, there are large gaps in the evidence base and more large controlled trials are warranted.
authors.affiliation: The Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: Roman
authors.initials: R
authors.lastname: Cregg
authors.forename: Sibtain
authors.initials: S
authors.lastname: Anwar
authors.forename: Paul
authors.initials: P
authors.lastname: Farquhar-Smith
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery; D059248:Chemoradiotherapy / Q000009:adverse effects; D002908:Chronic Disease; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000150:complications; D009369:Neoplasms / Q000150:complications / Q000601:surgery; D009437:Neuralgia / Q000209:etiology; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors; D019616:Thoracic Surgical Procedures / Q000009:adverse effects