Chronic postsurgical pain following gastrointestinal surgery - A scoping review

BACKGROUND: Chronic postsurgical pain (CPSP) has a great impact on quality of life and socioeconomic status. The mechanisms behind CPSP remain poorly understood, however type of surgical intervention seems to play a role. Gastrointestinal surgeries are common procedures, yet research in CPSP following gastrointestinal surgery is limited. The objective of this scoping review was to map the current literature on CPSP following gastrointestinal surgery, identifying how CPSP have been investigated, and which evidence gaps exist.

METHODS: This scoping review followed a pre-published protocol and PRISMA-ScR guidelines. A search was carried out in Medline, Embase, CINAHL, Cochrane Central, Clinicaltrials.Gov, and Google Scholar. Eligible studies were original studies involving adults, undergoing gastrointestinal surgery, who had a pain assessment ≥30 days postoperatively. A two-phase screening process and data charting were done by two independent reviewers.

RESULTS: A total of 53 studies were included, published between 2001 and 2024, predominantly across Europe and Asia. The range of CPSP prevalence reported was 3.3%-46.1%. Only half the studies clearly defined CPSP, and the timing and manner of pain assessment varied considerably. Twenty-seven studies assessed risk factors for developing CPSP: preoperative pain and acute postoperative pain were consistently significant.

CONCLUSIONS: There was a wide consensus on CPSPs' negative impact on quality of life. CPSP following gastrointestinal surgery is prevalent and significantly impacts quality of life. Standardized definitions and methodologies to improve the comparability and reliability of the findings across studies are needed. Future research should focus on CPSP following specific surgical procedures to develop tailored prevention and treatment strategies.