Abstract
BACKGROUND: Refractory neuropathic inguinodynia following inguinal herniorrhaphy is a common and debilitating complication. This prospective study evaluated long-term outcomes associated with laparoscopic retroperitoneal triple neurectomy.
METHODS: Sixty-two consecutive patients (51 male; mean age, 47); all failing pain management; prior reoperation in 35, prior neurectomy in 26; average follow-up 681 days (range: 90 days to 3 years). Measured outcomes include numeric pain ratings, dermatomal mapping, histologic confirmation, quantitative sensory testing, complications, narcotic usage, and activity level.
RESULTS: Mean numerical pain scores were significantly decreased (baseline, 8.6) at all postoperative time points (POD 1, 3.6; P < .001: POD 90, 2.3, P < .001) with durable efficacy from POD 90 to 3 years (P < .001). Quantitative sensory testing showed marked group-level increases of sensory thresholds. Narcotic dependence decreased in 57/62 and was eliminated in 44/62 and activity level improved in 58/62.
CONCLUSIONS: Retroperitoneal triple neurectomy is an effective and durable treatment for refractory neuropathic inguinodynia.
| Original language | English |
|---|---|
| Pages (from-to) | 1126-1132 |
| Number of pages | 7 |
| Journal | The American Journal of Surgery |
| Volume | 212 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2016 Dec |
| Externally published | Yes |
Subject classification (UKÄ)
- Surgery
Free keywords
- Adult
- Aged
- Denervation
- Female
- Hernia, Inguinal
- Herniorrhaphy
- Humans
- Laparoscopy
- Male
- Middle Aged
- Neuralgia
- Pain, Postoperative
- Prospective Studies
- Treatment Outcome
- Young Adult
- Journal Article