445 Chronic Pain After Lichtenstein and Posterior Mesh Hernia Repair

Erhan, Yamaç; Erhan, Elvan; Aydede, Hasan; Mercan, Metin; Tok, Demet

doi:10.1016/s1090-3801(06)60448-5

Cited by 23 publications

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“…Chronic groin pain has been reported in many studies (Erhan et al 28 reported 4-6% of patients having chronic pain after Lichtenstein and preperitoneal hernia repair and Phoolbalan et al 29 reported a 10% incidence of pain after inguinal herniorrhaphy). Several risk factors seems to play an important role in the development of chronic groin pain, such as surgeons experience, day care surgeries, intensity of immediate postoperative pain and degree of specialization 28,29 .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…Several risk factors seems to play an important role in the development of chronic groin pain, such as surgeons experience, day care surgeries, intensity of immediate postoperative pain and degree of specialization 28,29 . One author quoted a 20% rate of nerve entrapment 30 but studies rarely mentioned whether surgeons identified the Ilioinguinal nerve or Iliohypogastric nerve during open dissection or not 31 .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

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Inguinal hernias in patients of 50 years and above. Pattern and outcome

Shyam

Rapsang

2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTObjective: Objective: Objective: Objective: Objective: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. Methods:Methods: Methods: Methods: Methods: a prospective descriptive study of patients (n=57) > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. Results:Results: Results: Results: Results: the most representative age group was 61-70 years, and all patients were male. 52 (91.22%) patients had unilateral inguinal hernias, while five (8.77%) had bilateral hernias. In 50 (87.71%) patients, the hernia was uncomplicated, while seven (12.28%) patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71%) patients while seven (12.28%) patients were operated in emergency. Postoperatively, 50 (87.7%) patients had uneventful recovery, while seven (12.28%) patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate preoperative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

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Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Inguinal hernias in patients of 50 years and above. Pattern and outcome

Shyam

Rapsang

2013

Rev. Col. Bras. Cir.

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“…Although assessment of inguinal hernia surgery has focused on recurrence, complications and costs, more recently there was an increased attention on chronic pain, discomfort and quality of life [21]. Definition of chronic pain relies on its chronicity lasting usually more than 3 months; however, there are several reports with different definitions of chronic pain indicating difficulty in classification, grading and measurement [1,2,10,21].…”

Section: Discussionmentioning

confidence: 99%

“…Definition of chronic pain relies on its chronicity lasting usually more than 3 months; however, there are several reports with different definitions of chronic pain indicating difficulty in classification, grading and measurement [1,2,10,21]. Patient-reported outcomes such as pain were believed to be an important index for improving outcomes in hernia surgery [8].…”

Section: Discussionmentioning

confidence: 99%

İnguinal herninin günübirlik cerrahisi: Cerrahi asistanları tarafından lokal anestezi altında gerçekleştirilen Lichtenstein inguinal herni onarımı

Subasi¹,

Yücel²,

Hasbahçeci³

et al. 2016

Archives of Clinical and Experimental Medicine

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Aim: Lichtenstein inguinal hernia repair with local anesthesia as a day-case surgery is one of aspects of education in inguinal hernia surgery as a surgical training program. In this study, we aimed to present these surgery performed by residents. Material and Methods: Forty years and older male patients diagnosed as primary inguinal hernia were included prospectively between June 2009 and March 2011. Surgical outcomes with respect to recurrence and chronic postoperative pain were studied. Results: There were 151 patients with a mean age of 55.7±10.8. Intraoperative evaluation revealed direct in 84 (55.6%), indirect in 58 (38.4%) and combined hernia in nine (6.0%). Mean operation time was 51.2±13.2 minutes which was significantly higher in obese patients (p<0.05). Patients were discharged at postoperatively eight hours or less in 143 (94.7%). Most of the patients (90.7%) were reported to choose local anesthesia again. Eleven and four patients reported pain scores of 0.23±0.7 (range 0-4) and 0.07±0.4 (range 0-3) at 6th and 12th month evaluations, respectively. At the postoperative 1st day, 137 (90.7%) patients could return to daily activities. There were 28 (18.5%) hematoma and seroma formation, and 18 (11.9%) wound infection. There was no mesh reaction; however, two (1.3%) recurrences were detected after one year of the operation. Conclusion: Lichtenstein inguinal hernia repair under local anesthesia as a day case surgery should be chosen as a primary treatment method, and can be performed by surgical residents under supervision in a safe manner. Keywords: Hernia repair, Local anesthesia, Day-case surgery Öz Amaç: Lokal anestezi ile günü birlik cerrahi olarak uygulanan Lichtenstein inguinal herni onarımı, cerrahi eğitim programı kapsamın yapılan eğitimlerin başında gelmektedir. Bu çalışmada, asisten hekimlerin yaptığı bu ameliyatı incelemeyi amaçladık. Gereç ve Yöntemler: Primer inguinal herni tanısı alan 40 yaş ve üstü erkek hastalar, Haziran 2009-Mart 2011 arasında ileriye dönük olarak çalışmaya dahil edildi. Tekrarlama ve kronik postoperatif ağrı açısından cerrahi sonuçlar çalışıldı. Bulgular: Yaş ortalaması 55,7±10,8 olan 151 hasta vardı. İntraoperatif değerlendirme 84 (%55,6) direk fıtık, 58 (%38,4) indirekt ve dokuz (%6,0) direk-indirekt fıtık birlikteliği vardı. Ortalama operasyon süresi 51,2 ±13,2 dakikaydı ve bu obez hastalarda anlamlı derecede yüksekti (p<0,05). Postoperatif dönemde 143 (%94,7) hasta, ilk sekiz saat içinde taburcu edildi. Hastaların çoğu (%90,7) lokal anesteziyi tekrar seçeceğini ifade etti. Onbir hastanın ağrı skoru 6. ve 12. ay değerlendirmelerinde 0,23±0,7 (dağılım 0-4) ve 0,07±0,4 (dağılım 0-3) olarak tespit edildi. Postoperatif 1. günde, 137 (%90,7) hasta günlük aktivitelerine geri döndü. 28 (%18,5) hematom ve seroma oluşumu ve 18 (%11,9) yara enfeksiyonu vardı. Mesh reaksiyonu saptanmadı; Ancak bir yıl operasyondan sonra iki (%1.3) rekürrens tespit edildi. Sonuç: Lichtenstein inguinal herni onarımı, lokal anestezi altında günlük cerrahi girişim olarak birincil tedavi yön...

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“…While the surgical treatment methods include type of surgery, use of lightweight meshes, non-staple treatments, and a laparoscopic approach, independently of the surgical technique, medical treatment methods include the use of opioids and analgesics, regional nerve block, and post-incisional local anesthetic administration. Although the purpose of modifications to the surgical procedure is to reduce the process of inflammation in the surgical field, the effect remains unclear (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Effect of Peritoneal Incision on Immediate Pain After Inguinal Hernia Repair: A Prospective Cohort Study

Tanrıkulu

Cagsar

Yalcin

et al. 2015

International Surgery

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Objective: Hernia repair is a common surgical procedure, and postoperative pain is an inevitable result of hernia surgery. The prevention of postoperative pain is of considerable importance in terms of patient comfort and early discharge. In this study, we evaluated the effects of a peritoneal incision on pain in the early postoperative period.Summary of Background Data: This was a prospective clinical study with 75 patients undergoing inguinal hernia repair. Methods: Patients were divided into five groups: group 1: indirect hernia, Lichtenstein repair with peritoneal incision, group 2: indirect hernia, Lichtenstein repair without peritoneal incision, group 3: all hernias, trans-abdominal preperitoneal(TAPP) repair, group 4: all hernias, total extraperitoneal (TEP) repair, and group 5: direct hernia, Lichtenstein repair with no peritoneal incision. Groups were compared in terms of postoperative pain scores at three different times and complications.Results: There were 62 males and 13 females; their average age was 51.25 years. The visual analog scale (VAS) scores were lower in groups 2, 4, and 5, and there were differences among groups and within each group according to VAS changes assessed at all time points (p < 0.05). There was no difference, according to VAS analysis, between open and laparoscopic surgery groups. There was a difference according to VAS changes in each group between hernia sides (p < 0.001).Conclusion: Peritoneal incision is a significant risk factor for postoperative pain after inguinal hernia repair. But, surgical procedure was not a risk factor although VAS scores were higher in open than laparoscopic surgery.

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445 Chronic Pain After Lichtenstein and Posterior Mesh Hernia Repair

Cited by 23 publications

References 0 publications

Inguinal hernias in patients of 50 years and above. Pattern and outcome

Inguinal hernias in patients of 50 years and above. Pattern and outcome

İnguinal herninin günübirlik cerrahisi: Cerrahi asistanları tarafından lokal anestezi altında gerçekleştirilen Lichtenstein inguinal herni onarımı

Effect of Peritoneal Incision on Immediate Pain After Inguinal Hernia Repair: A Prospective Cohort Study

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