title: Prevalence, characteristics and risk factors of chronic postsurgical pain after laparoscopic colorectal surgery: Retrospective analysis.
abstract: BACKGROUND
  The prevalence of chronic postsurgical pain (CPSP) is a critical medical problem with economic implications. Its prevalence after gastrointestinal surgery is not well documented, particularly when a laparoscopic approach is used.
  
  
  OBJECTIVE
  The aim of the study was to determine the prevalence, the characteristics and the risk factors for CPSP after laparoscopic colorectal surgery.
  
  
  METHODS
  A retrospective analysis using a postal questionnaire.
  
  
  METHODS
  The study was conducted at a university teaching hospital.
  
  
  METHODS
  Patients who underwent laparoscopic colorectal surgery from April 2008 until December 2011 (n = 260). No epidural analgesia was used.
  
  
  METHODS
  Postoperative pain intensity, incidence and characteristics of CPSP, and impact on quality of life and sleep.
  
  
  RESULTS
  Of 199 responses, 33 patients (17%) reported chronic pain at a median [interquartile range, IQR] of 38 [27 to 55] months after laparoscopic surgery with a median intensity of 4 [3 to 5]. CPSP had a negative impact on the quality of life in 84% of patients and on sleep in 43%. CPSP required regular analgesic(s) intake in 54% patients. Using a backward stepwise multivariate logistic regression model, the following variables were determined as independent risk factors for CPSP: redo surgery for anastomotic leakage (P = 0.01), inflammatory bowel disease (IBD) as the indication for surgery (P = 0.01) and preoperative pain (P = 0.05).
  
  
  CONCLUSIONS
  The incidence of CPSP after laparoscopic colorectal surgery (17%) is similar to those reported in the literature after laparotomy. Risk factors are redo surgery for postoperative peritonitis, IBD and preoperative pain.
  
  
  BACKGROUND
  EudraCT 2012-005712-25.
authors.affiliation: From the Department of Anaesthesiology and Intensive Care Medicine (JLJ, MJG, KM, DL, GD, CCR, JFEB), and Department of Abdominal Surgery and Transplantation, CHU of Liege, University of Liege, Liege, Belgium (CIC, LPK).
authors.forename: Jean L
authors.initials: JL
authors.lastname: Joris
authors.forename: Mathieu J
authors.initials: MJ
authors.lastname: Georges
authors.forename: Kamel
authors.initials: K
authors.lastname: Medjahed
authors.forename: Didier
authors.initials: D
authors.lastname: Ledoux
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Damilot
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Ramquet
authors.forename: Carla I
authors.initials: CI
authors.lastname: Coimbra
authors.forename: Laurent P
authors.initials: LP
authors.lastname: Kohnen
authors.forename: Jean François E
authors.initials: JF
authors.lastname: Brichant
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010149:Postoperative Pain / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics