Inguinal hernia recurrence after laparoscopic mesh removal for chronic pain: a single-center experience with 11 years of practice.

Autor: Chaoui AM; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands. ahmed.chaoui@mmc.nl., Rops JP; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands., van Dijk WA; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands., Loos MJA; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands., Scheltinga MRM; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands., Zwaans WAR; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands.; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands., Slooter GD; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medical Center, Eindhoven, The Netherlands.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Nov 11. Date of Electronic Publication: 2024 Nov 11.
DOI: 10.1007/s00464-024-11354-0
Abstrakt: Introduction: Up to 12% of patients undergoing minimally invasive inguinal hernia repair may develop chronic postoperative inguinal pain (CPIP), possibly explained by the presence of mesh. Recent studies reported that laparoscopic mesh removal is feasible and safe. However, the risk of a hernia recurrence is unknown. This observational study describes the rate of hernia recurrence and evolution in pain score following laparoscopic mesh removal for CPIP after preperitoneal inguinal hernia repair.
Methods: Prospectively collected questionnaires and operative notes of consecutive patients undergoing a laparoscopic mesh removal for CPIP in our center of expertise between November 2011 and July 2022 were studied. Pain scores were quantified using the Numeric Pain Rating Scale (NRS, 0-10). The presence of a hernia recurrence was based on patient history and clinical findings.
Results: A total of 89 patients underwent laparoscopic mesh removal, and data of 83 patients (93% response rate) were available for analysis. Median decrease in pain score (NRS) after mesh removal was 4 (range + 2 to - 9). After a median 4.3 years follow up period, a hernia recurrence was present in 18 patients (21.7%). Of these, eight were symptomatic requiring correction using a Lichtenstein repair with a favorable outcome whereas a wait-and-see approach was successfully followed in the remaining 10 patients.
Conclusion: Laparoscopic mesh removal for CPIP following preperitoneal inguinal hernia repair resulted in an inguinal hernia recurrence in one of five patients requiring remedial surgery in one in ten patients. This knowledge may inform the preoperative counseling process.
Competing Interests: Declarations Disclosures Ahmed M. Chaoui, Jonas P. Rops, William Van Dijk, Marc Scheltinga, Willem Zwaans and Gerrit Slooter have no conflicts of interest or financial ties to disclose.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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