Predictive factors of post-laparoscopic inguinal hernia acute and chronic pain: prospective follow-up of 807 patients from a single experienced surgeon

Lo, Chi Wen; Chen, Yung Tai; Jaw, Fu Shan; Yu, Chih-Chin; Tsai, Yao Chou

doi:10.1007/s00464-020-07373-2

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…Several studies reported that the extent of pain during the first week after surgery was associated with the rate of chronic pain [ 19 , 20 ]; however, in our study, the pain score during the early postoperative periods was not related to the incidence of chronic pain. Although a previous study reported that BPH history was not related to chronic pain [ 16 ], we found the opposite, and further studies are needed to clarify this relationship. The cause of chronic pain after a hernia surgery can be multifactorial and cannot be identified clearly, in many patients.…”

Section: Discussioncontrasting

confidence: 90%

“…However, Wei et al [ 12 ] reported similar postoperative pain between the two methods. Although postoperative pain is influenced by the kinds of mesh and fixation modalities [ 13 – 16 ], we used the same type of mesh and fixation modalities for both techniques and were able to exclude the influence of the material. In our study, the operation time was slightly longer in the TAPP than in the TEP group, and it is likely that this reflected the time needed to open and close the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic repair of inguinal hernias: Risk factors for urinary retention and chronic pain after totally extraperitoneal repair and transabdominal preperitoneal repair

Kim

Son

Lee

et al. 2021

J Minim Invasive Surg

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Purpose There are various opinions about the postoperative complications of the two methods for laparoscopic inguinal hernia surgery; totally extraperitoneal repair (TEP) and transabdominal preperitoneal repair (TAPP). The aim of this study was to compare the postoperative course after TAPP and TEP, focusing on immediate postoperative pain, incidence of postoperative urinary retention (POUR), and chronic pain. Methods This study retrospectively analyzed a consecutive series of 344 inguinal hernia patients who were treated with laparoscopic surgery between November 2016 and December 2019 at a single tertiary referral center. Results Patient demographics did not differ significantly between the groups. The operation time was significantly shorter in the TEP group than in the TAPP group (43.1 ± 14.9 minutes vs. 63.5 ± 16.5 minutes, p < 0.001). The postoperative pain scores were significantly lower in the TEP group than in the TAPP group immediately (3.6 ± 1.3 vs. 4.4 ± 1.1, p < 0.001) and 6 hours (1.5 ± 1.4 vs. 2.3 ± 1.8, p < 0.001) after the operation. The other complications did not differ significantly between the groups. Age was a significant risk factor for POUR (odds ratio [OR], 1.083; 95% confidence interval [CI], 1.018–1.151; p = 0.011), and history of benign prostate hyperplasia (BPH) was a significant risk factor for chronic pain (OR, 5.363; 95% CI, 1.028–27.962; p = 0.046). Conclusion TEP and TAPP seem to be safe and effective for laparoscopic inguinal hernia repair and have similar postoperative outcomes. Age was a significant risk factor for POUR, and BPH history was a significant risk factor for chronic pain.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of inguinal hernias: Risk factors for urinary retention and chronic pain after totally extraperitoneal repair and transabdominal preperitoneal repair

Kim

Son

Lee

et al. 2021

J Minim Invasive Surg

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“…Some reports have indicated that light weight mesh can reduce the incidence of chronic pain. 32 Thus, more studies concerning mesh weight and chronic pain are needed. Third, the performance and detection bias were high in most of our eligible studies due to the dissatisfactory blinding, which is quite challenging for clinical interventions such as operations.…”

Section: Limitationsmentioning

confidence: 99%

Mesh Fixation Versus Nonfixation in Laparoscopic Inguinal Hernia Repair: A Systematic Review and Meta-Analysis

Hao

et al. 2023

The American Surgeon™

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Background It remains controversial whether mesh should be fixed during laparoscopic inguinal hernia repair. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was conducted to compare fixation and nonfixation in laparoscopic groin hernia repair. Methods A registration was listed with PROSPERO (International Prospective Register of Systematic Reviews; registration no. CRD42022350469). Databases including PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched to identify RCTs comparing fixation with nonfixation in laparoscopic groin hernia repair. The primary outcomes were postoperative pain at 24 hours and recurrence. Secondary outcomes were mean operative time, urinary retention, and postoperative pain at 6 months. Results A total of 18 trials, including 2617 patients with 2878 hernias, were included in this meta-analysis. In contrast to the fixation group, the nonfixation group was associated with lower postoperative pain scores at 24 hours and 6 months, a shorter mean operative time, and a lower incidence of urinary retention. There were no significant differences between the 2 types of procedures in terms of the rate of recurrence for patients with an inguinal hernia orifice smaller than 4 cm in size. Conclusions The nonfixation technique is an effective method to reduce urinary retention, mean operative time, and postoperative pain at 24 hours and at 6 months; however, the rate of recurrence was comparable to that of the fixation method.

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“…Ageing seems to increase pain thresholds, reducing pain sensitivity for lower pain intensities [47]. Neuroangiogenesis can also be seen as an important factor in younger patients, making them prone to persistent postoperative pain [48].…”

Section: Ta B L E 2 Group a Versus Group B: Long-term Outcomementioning

confidence: 99%

Pelvic pain is a common prolapse symptom and improvement after ventral mesh rectopexy is more frequent than deterioration or de novo pain

et al. 2022

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Aim The aim of this work was to assess the relationship between pelvic pain and rectal prolapse both before prolapse surgery and in the long term after ventral mesh rectopexy (VMR). Method Patients undergoing VMR between 2004 and 2017 were contacted. Outcomes including the severity of pelvic pain were recorded using a numeric rating scale. Results Four hundred and seventy eight of the 749 patients (64%) were successfully contacted. Of these, 39% reported pre‐existing pelvic pain prior to VMR (group A) and 61% were pain free (group B). The median follow‐up time was 8.0 years (interquartile range 5.0–10.0 years). Symptoms of obstructed defaecation were significantly more common (p = 0.002) in group A (91/187, 49%) than in group B (101/291, 35%). In contrast, faecal incontinence was more common (p = 0.007) in group B (75/291, 26%) than in group A (29/187, 15%). In group A, 76% showed improvement in pelvic pain after VMR: 61% were pain free and 39% had partial improvement in their pre‐existing pelvic pain. Patients with persistent pelvic pain were younger (p = 0.01) and more likely to have revisional surgery after VMR (p = 0.0003), but there was no relation to the indication for surgery (p = 0.59). In group B, 15% reported de novo pelvic pain after VMR, and this was more common in women under 50 years old (p = 0.001), when obstructed defaecation was the indication (p = 0.03), in mesh erosion (p = <0.05) and when associated with revisional surgery (p = 0.005). Conclusion Pelvic pain is common (39%) in patients undergoing prolapse surgery, and VMR improves this pain in most patients (76%). However, a significant number of patients fail to improve (12%), experience worsening of pain (12%) or develop de novo pelvic pain (15%).

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Predictive factors of post-laparoscopic inguinal hernia acute and chronic pain: prospective follow-up of 807 patients from a single experienced surgeon

Cited by 12 publications

References 33 publications

Laparoscopic repair of inguinal hernias: Risk factors for urinary retention and chronic pain after totally extraperitoneal repair and transabdominal preperitoneal repair

Laparoscopic repair of inguinal hernias: Risk factors for urinary retention and chronic pain after totally extraperitoneal repair and transabdominal preperitoneal repair

Mesh Fixation Versus Nonfixation in Laparoscopic Inguinal Hernia Repair: A Systematic Review and Meta-Analysis

Pelvic pain is a common prolapse symptom and improvement after ventral mesh rectopexy is more frequent than deterioration or de novo pain

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