Neurectomy versus Nerve Sparing in Open Inguinal Hernia Repair: A Randomised Controlled Trial.

Autor: Changazi SH; Department of General Surgery, Services Hospital, Lahore, Pakistan., Fatimah N; Department of General Surgery, Services Hospital, Lahore, Pakistan., Naseer A; Department of General Surgery, Services Hospital, Lahore, Pakistan., Wadood A; Department of General Surgery, Services Hospital, Lahore, Pakistan., Ahmad QA; Department of General Surgery, Services Hospital, Lahore, Pakistan., Ayyaz M; Department of General Surgery, Services Hospital, Lahore, Pakistan.
Jazyk: angličtina
Zdroj: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP [J Coll Physicians Surg Pak] 2020 Sep; Vol. 30 (9), pp. 917-920.
DOI: 10.29271/jcpsp.2020.09.917
Abstrakt: Objective:  To determine the effect of neurectomy in reducing the frequency of chronic inguinodynia after mesh hernioplasty in open inguinal hernia repair.
Study Design: Single blind randomised controlled-trial.
Place and Duration of Study: Surgical Unit-I, Department of General Surgery, Services Hospital, Lahore, Pakistan from September 2018 to September 2019.
Methodology: All male patients undergoing open groin hernia surgery were included in the study. A total of 100 patients were randomly categorised into group A (neurectomy group) and group B (nerve sparing group). Patients were followed up for three months for the development of chronic inguinodynia. Signifiance was determined at p <0.05 using Chi-square and Fisher's exact tests.
Results: Out of 100 patients, 50 patients were enrolled in group A, while 50 were enrolled in group B. Mean age of patients was 42.1 ± 17.5 years. The median (IQR) acute pain score in neurectomy group was 3.0 (2.0-4.0), while median (IQR) acute pain score was 4.0 (3.0-6.0) in nerve sparing group with statistically significant difference (z = -3.256, p = 0.001). The frequency of chronic inguinodynia was significantly less in group A compared to group B [3 (6%) vs. 13 (26%), p = 0.012].
Conclusion: Excision of ilioinguinal and iliohypogastric nerve in inguinal mesh hernioplasty reduces the frequency of chronic inguinodynia. Ilioinguinal neurectomy may be practised routinely in patients undergoing Lichtenstein mesh hernioplasty.   Key Words: Inguinal neurectomy, Inguinal hernia, Chronic inguinodynia, Lichtenstein mesh hernioplasty.
Databáze: MEDLINE