scholarly journals Portuguese Inguinal Hernia Cohort (PINE) study

2020 ◽  
Author(s):  
◽  
J Simões ◽  
AA João ◽  
JM Azevedo ◽  
M Peyroteo ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cohort Study ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Collaborative Research ◽  
Research Network ◽  
Hernia Surgery ◽  
Inguinal Pain ◽  
Chronic Postoperative Inguinal Pain

AbstractPurposeRecent comprehensive guidelines have been published on the management of inguinal hernia. Contrary to other European countries, no Portuguese hernia registry exists. This represents an opportunity to assess outcomes of hernia surgery in the Portuguese population. The primary aim is to define the prevalence of chronic pain after elective inguinal hernia repair. The secondary aims are to identify risk factors for chronic pain after elective inguinal hernia repair, to characterise the management of elective inguinal hernia in public Portuguese hospitals.MethodsProspective national cohort study of patients submitted to elective inguinal hernia repair. The primary outcome is the prevalence of chronic postoperative inguinal pain, according to the EuraHS QoL questionnaire at 3 months postoperatively. The study will be delivered in all Portuguese regions through a collaborative research network. Four 2-week inclusion periods will be open for recruitment. A site-specific questionnaire will capture procedure volume and logistical facilities for hernia surgery.ConclusionThis protocol describes the methodology of a prospective cohort study on the elective management of inguinal hernia. It discusses key challenges and describes how the results will impact future investigation. The study will be conducted across a nationwide collaborative research network, with prospective quality assurance and data validation strategies. It will provide the basis for a more accurate prediction of chronic postoperative inguinal pain and the research on adequate patient selection strategies for surgery and therapeutic strategies for postoperative pain.

scholarly journals Nationwide Results on Chronic Pain After Bilateral Transabdominal Preperitoneal Inguinal Hernia Repair

2019 ◽  
Vol 109 (4) ◽  
pp. 289-294
Author(s):  
N. Johansen ◽  
C. D. Vyrdal ◽  
T. Bisgaard
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Performance Status ◽  
Assessment Scale ◽  
Activity Assessment ◽  
Transabdominal Preperitoneal ◽  
Inguinal Pain ◽  
Chronic Postoperative Inguinal Pain ◽  
Transabdominal Preperitoneal Inguinal Hernia

Background: Majority of studies on chronic postoperative inguinal pain has described the occurrence after unilateral inguinal hernia repair. Endo-laparoscopic repair, for example, laparoscopic transabdominal preperitoneal inguinal hernia repair, has been recommended for primary bilateral symptomatic inguinal hernias, although the literature on chronic postoperative inguinal pain among this type of patients is limited. The present study analyzed chronic postoperative inguinal pain following bilateral transabdominal preperitoneal inguinal hernia repair. Methods: Nationwide consecutive patients who underwent bilateral transabdominal preperitoneal inguinal hernia repair (July 2012–June 2013) were recruited from the Danish Inguinal Hernia Database and cross-checked with hospital files and the National Patient Registry. A prospective follow-up was performed with a standardized postal questionnaire including questions on functional performance status assessed by a modified version of the Activity Assessment Scale. The primary outcome was incidence of chronic postoperative inguinal pain defined as moderate to severe pain-related impairment of everyday activities. Pain was registered according to the two individual groin areas. Furthermore, the overall incidence of chronic postoperative inguinal pain per operated inguinal hernia was calculated. Intensity of experienced pain (Activity Assessment Scale score) was compared between patients reporting pain from one versus both groin areas. Results: In total, 209 patients (418 hernia repairs) were analyzed (questionnaire response rate 83%). The median follow-up time was 27 months (22–34 months). In total, 27 of 209 patients (13%) complained of chronic postoperative inguinal pain from either one ( n = 17) or both ( n = 10) groin areas after bilateral transabdominal preperitoneal inguinal hernia repair. The incidence of chronic inguinal pain per operated hernia was 9%. The intensity of impairment due to pain (Activity Assessment Scale score) did not differ significantly between patients with chronic postoperative inguinal pain in one (19%) versus both sides (30%), p = 0.056. Conclusion: Bilateral transabdominal preperitoneal inguinal hernia repair for symptomatic inguinal hernias was related to a high incidence (13%) of chronic postoperative inguinal pain and decreased functional performance status.

scholarly journals Chronic Pain after Inguinal Hernia Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mallikarjuna Manangi ◽  
Santhosh Shivashankar ◽  
Abhishek Vijayakumar
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Injury ◽  
Statistical Significance ◽  
Preemptive Analgesia ◽  
Preoperative Pain ◽  
Hernia Surgery

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

scholarly journals Dermatome Mapping Test in the analysis of anatomo-clinical correlations after inguinal hernia repair

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roberto Cirocchi ◽  
Isabella Mercurio ◽  
Claudio Nazzaro ◽  
Angelo De Sol ◽  
Carlo Boselli ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Observational Study ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Prospective Observational Study ◽  
Hernia Mesh ◽  
Inguinal Pain ◽  
Chronic Postoperative Inguinal Pain ◽  
Hernia Mesh Repair

Abstract Background Nerve identification is recommended in inguinal hernia repair to reduce or avoid postoperative pain. The aim of this prospective observational study was to identify nerve prevalence and find a correlation between neuroanatomy and chronic neuropathic postoperative inguinal pain (CPIP) after 6 months. Material A total of 115 patients, who underwent inguinal hernia mesh repair (Lichtenstein tension-free mesh repair) between July 2018 and January 2019, were included in this prospective observational study. The mean age and BMI respectively resulted 64 years and 25.8 with minimal inverse distribution of BMI with respect to age. Most of the hernias were direct (59.1%) and of medium dimension (47.8%). Furthermore, these patients were undergoing Dermatome Mapping Test in preoperatively and postoperatively 6 months evaluation. Results Identification rates of the iliohypogastric (IH), ilioinguinal (II) and genitofemoral (GF) nerves were 72.2%, 82.6% and 48.7% respectively. In the analysis of nerve prevalence according to BMI, the IH was statistically significant higher in patients with BMI < 25 than BMI ≥ 25 P (< 0.05). After inguinal hernia mesh repair, 8 patients (6.9%) had chronic postoperative neuropathic inguinal pain after 6 months. The CPIP prevailed at II/GF dermatome. The relation between the identification/neurectomy of the II nerve and chronic postoperative inguinal pain after 6 months was not significant (P = 0.542). Conclusion The anatomy of inguinal nerve is very heterogeneous and for this reason an accurate knowledge of these variations is needed during the open mesh repair of inguinal hernias. The new results of our analysis is the statistically significant higher IH nerve prevalence in patients with BMI < 25; probably the identification of inguinal nerve is more complex in obese patients. In the chronic postoperative inguinal pain, the II nerve may have a predominant role in determining postoperative long-term symptoms. Dermatome Mapping Test in an easy and safe method for preoperative and postoperative 6 months evaluation of groin pain. The most important evidence of our analysis is that the prevalence of chronic pain is higher when the nerves were not identified.

scholarly journals Telephone survey of inguinal hernia repair patients older than 5 years for chronic pain

2018 ◽  
Vol 5 (6) ◽  
pp. 2045
Author(s):  
Didem Baskın Embleton ◽  
Ahmet A. Tuncer ◽  
Salih Çetinkurşun
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Telephone Survey ◽  
Small Sample ◽  
Hernia Surgery ◽  
Old Patients ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernia Surgery

Background: Little is known about chronic pain in the inguinal region following inguinal hernia repair in children. A study was conducted to examine whether pain is an important complication of inguinal hernia surgery in children.Methods: A telephone survey was performed of former patients who had undergone inguinal hernia repair and are now older than 5 years. A questionnaire was prepared and the questions were asked by paediatric surgeons.Results: There were 66 former patients now older than 5 years old. Patients had inguinal hernia repair at between 11 days and 14 years of age (mean 3.24 years). Age during telephone survey was between 5 and 18 years (mean 7.48 years). One patient had late pain related to direct inguinal hernia occurrence (1.5%). Three patients described non-specific abdominal pain unrelated to the inguinal operation. None of the patients were taking painkillers.Conclusions: Although this is a small sample group, chronic pain does not seem to be a serious problem after inguinal hernia repair in children.

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