Chronic Postoperative Pain after Robot-Assisted Laparoscopic Hysterectomy for Endometrial Cancer

Abstract

Objective: Chronic postoperative pain poses a significant clinical challenge and is associated with a reduced quality of life and increased use of health services. The present study was conducted to determine the prevalence of chronic postoperative pain and potential risk factors for developing chronic postoperative pain after robot-assisted laparoscopic hysterectomy. Materials and Methods: This was a questionnaire-based, cross-sectional retrospective study. Patients treated for endometrial cancer with robot-assisted laparoscopic hysterectomy from January 2010 until July 2015 received a validated questionnaire. The questionnaire had 32 questions related to preoperative and the postoperative conditions and was used to assess the presence of preoperative pelvic pain, chronic postoperative pelvic pain, pain intensity ratings, frequency and location of pain, pain during everyday activities, and demographic data. The medical records were reviewed for details concerning body mass index, duration of surgery, blood loss during surgery, histopathologic diagnoses, and stages of cancer. Results: Questionnaires were sent to 272 patients and 207 (76.1%) responded. The prevalence of chronic postoperative pain was 14.9%. It was predominantly localized to dermatomes T-12-L-3 and S2-S4. Significant risk factors for chronic postoperative pain were preoperative pelvic pain (odds ratio [OR]: 4.99) and a high level of acute postoperative pain (OR: 1.27) (p < 0.05). Conclusions: The prevalence of chronic postoperative pain after robot-assisted laparoscopic hysterectomy was 14.9%. Risk factors were preoperative pelvic pain and a high level of acute postoperative pain, indicating that these factors should be included when counseling patients and that research efforts should be taken to find ways to minimize the postoperative impact of these factors.