Clinical characteristics and risk factors of chronic pain after laparoscopic inguinal hernia repair_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YAN Huidi , ZHOU Lixin , WANG Maolin , LIN Peiyi , SU Jiqin

Department of General Surgery and Hepatobiliary Surgery, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian 361021, P. R. China;

Corresponding?author：

YAN Huidi, Email: yhd351252@163.com

Keywords：

chronic pain; inguinal hernia; transperitoneal preperitoneal hernia repair; totally extraperitoneal hernia repair; laparoscopy

DOI：

10.7507/1007-9424.201810040

Video：

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Objective To investigate the clinical characteristics and risk factors of chronic pain after laparoscopic inguinal hernia repair.Methods The clinical data of 142 cases underwent laparoscopic inguinal hernia repair from January 2013 to December 2017 in The Second Affiliated Hospital of Xiamen Medical College were retrospectively analyzed.Results The incidence of chronic pain after laparoscopic inguinal hernia repair was 12.7% (18/142), and 83.3% (15/18) of the patients were located in the inguinal region. Univariate analysis showed that postoperative chronic pain rates were higher in patients receiving standard patch, large patch, mechanical fixation patch, and with postoperative complications (P<0.05). Multivariate analysis showed that large patch [OR=1.82, 95% CI was (1.18, 5.36), P=0.023], mechanical fixation patch [OR=1.44, 95% CI was (1.07, 3.62), P=0.039], and postoperative complications [OR=2.53, 95% CI was (1.27, 7.31), P=0.011] were independent risk factors for postoperative chronic pain after laparoscopic inguinal hernia repair.Conclusion The occurrence of chronic pain after laparoscopic inguinal hernia repair is the result of many factors, especially the complications and patch factors.

Citation： YAN Huidi, ZHOU Lixin, WANG Maolin, LIN Peiyi, SU Jiqin. Clinical characteristics and risk factors of chronic pain after laparoscopic inguinal hernia repair. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(2): 180-184. doi: 10.7507/1007-9424.201810040 Copy

1.	嚴輝弟, 肖春林, 王茂林, 等. 腹腔鏡完全腹膜外免釘合腹股溝疝修補術 45 例. 中國微創外科雜志, 2010, 10(10): 942-944.
2.	王平, 黃永剛. 腹股溝疝術后慢性疼痛處理流程國際共識解讀. 中華疝和腹壁外科雜志: 電子版, 2018, 12(1): 6-9.
3.	Lange JF, Kaufmann R, Wijsmuller AR, et al. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia, 2015, 19(1): 33-43.
4.	趙渝, 王剛. 腹股溝疝修補術后慢性疼痛的原因及治療. 中國實用外科雜志, 2006, 26(11): 826-828.
5.	Takata H, Matsutani T, Hagiwara N, et al. Assessment of the incidence of chronic pain and discomfort after primary inguinal hernia repair. J Surg Res, 2016, 206(2): 391-397.
6.	Staerkle RF, Vuille-Dit-Bille RN, Fink L, et al. Chronic pain and quality of life after inguinal hernia repair using the COMI-hernia score. Langenbecks Arch Surg, 2017, 402(6): 935-947.
7.	楊華, 王俊偉, 彭雪峰, 等. 腹腔鏡和開放式無張力疝修補術對患者術后早期疼痛的影響. 中國普外基礎與臨床雜志, 2016, 23(11): 1384-1388.
8.	陳士德, 李向國, 汪曉峰, 等. 自固定補片在腹腔鏡完全腹膜外腹股溝疝修補術中的臨床應用. 中國普外基礎與臨床雜志, 2016, 23(3): 315-318.
9.	Nguyen DK, Amid PK, Chen DC. Groin pain after inguinal hernia repair. Adv Surg, 2016, 50(1): 203-220.
10.	何文, 黃耿文, 陽建怡. 腹腔鏡下腹股溝疝修補術后急慢性疼痛的影響因素. 中華疝和腹壁外科雜志: 電子版, 2016, 10(5): 329-332.
11.	黃永剛, 顧卯林, 郭呂, 等. 非編織聚丙烯補片免固定 TAPP 治療腹股溝疝的臨床應用(附 60 例報道). 中國普外基礎與臨床雜志, 2015, 22(1): 109-110.
12.	陳思夢, 劉力嘉. 腹股溝疝術后感染及慢性疼痛臨床處理. 中國實用外科雜志, 2014, 35(5): 398-400.
13.	Burgmans JP, Voorbrood CE, Van Dalen T, et al. Chronic pain after TEP inguinal hernia repair, does MRI reveal a cause? Hernia, 2016, 20(1): 55-62.
14.	Schopf S, von Ahnen T, von Ahnen M, et al. Chronic pain after laparoscopic transabdominal preperitoneal hernia repair: a randomized comparison of light and extralight titanized polypropylene mesh. World J Surg, 2011, 35(2): 302-310.
15.	Li W, Sun D, Sun Y, et al. The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation. Surg Endosc, 2017, 31(10): 4238-4243.
16.	Pommergaard HC, Burcharth J, Andresen K, et al. No difference in sexual dysfunction after transabdominal preperitoneal (TAPP) approach for inguinal hernia with fibrin sealant or tacks for mesh fixation. Surg Endosc, 2017, 31(2): 661-666.
17.	朱松, 侯克柱, 劉偉, 等. 腹腔鏡經腹腹膜前疝修補術使用免釘合 3D 補片治療老年腹股溝疝的體會. 腹腔鏡外科雜志, 2016, 21(2): 102-104.
18.	黨晨珀, 江道振, 劉晟, 等. 比較經腹腹膜前腹股溝疝修補術中應用 3D 免釘合補片與普通平片的臨床隨機對照試驗. 腹腔鏡外科雜志, 2015, 20(7): 543-546.
19.	曹景新. 免釘合補片腹腔鏡經腹腔腹膜前疝修補術治療腹股溝疝應用觀察. 中國普通外科雜志, 2012, 21(7): 908-910.
20.	Sun P, Cheng X, Deng S, et al. Mesh fixation with glue versus suture for chronic pain and recurrence in Lichtenstein inguinal hernioplasty. Cochrane Database Syst Rev, 2017, 2: CD010814.
21.	孟令勤, 楊福全. 腹股溝疝無張力修補術后慢性疼痛治療研究. 中國實用外科雜志, 2014, 34(5): 419-421.
22.	Niebuhr H, Wegner F, Hukauf M, et al. What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20, 004 patients from the Herniamed Registry. Surg Endosc, 2018, 32(4): 1971-1983.
23.	Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res, 2018, 11: 675-681.
24.	劉斌, 陳金輝. Lichtenstein無張力疝修補術中腹股溝區神經處理的體會. 中國普外基礎與臨床雜志, 2012, 19(3): 314-318.
25.	Chatzimavroudis G, Kalaitzis S, Voloudakis N, et al. Evaluation of four mesh fixation methods in an experimental model of ventral hernia repair. J Surg Res, 2017, 212: 253-259.

1. 嚴輝弟, 肖春林, 王茂林, 等. 腹腔鏡完全腹膜外免釘合腹股溝疝修補術 45 例. 中國微創外科雜志, 2010, 10(10): 942-944.
2. 王平, 黃永剛. 腹股溝疝術后慢性疼痛處理流程國際共識解讀. 中華疝和腹壁外科雜志: 電子版, 2018, 12(1): 6-9.
3. Lange JF, Kaufmann R, Wijsmuller AR, et al. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia, 2015, 19(1): 33-43.
4. 趙渝, 王剛. 腹股溝疝修補術后慢性疼痛的原因及治療. 中國實用外科雜志, 2006, 26(11): 826-828.
5. Takata H, Matsutani T, Hagiwara N, et al. Assessment of the incidence of chronic pain and discomfort after primary inguinal hernia repair. J Surg Res, 2016, 206(2): 391-397.
6. Staerkle RF, Vuille-Dit-Bille RN, Fink L, et al. Chronic pain and quality of life after inguinal hernia repair using the COMI-hernia score. Langenbecks Arch Surg, 2017, 402(6): 935-947.
7. 楊華, 王俊偉, 彭雪峰, 等. 腹腔鏡和開放式無張力疝修補術對患者術后早期疼痛的影響. 中國普外基礎與臨床雜志, 2016, 23(11): 1384-1388.
8. 陳士德, 李向國, 汪曉峰, 等. 自固定補片在腹腔鏡完全腹膜外腹股溝疝修補術中的臨床應用. 中國普外基礎與臨床雜志, 2016, 23(3): 315-318.
9. Nguyen DK, Amid PK, Chen DC. Groin pain after inguinal hernia repair. Adv Surg, 2016, 50(1): 203-220.
10. 何文, 黃耿文, 陽建怡. 腹腔鏡下腹股溝疝修補術后急慢性疼痛的影響因素. 中華疝和腹壁外科雜志: 電子版, 2016, 10(5): 329-332.
11. 黃永剛, 顧卯林, 郭呂, 等. 非編織聚丙烯補片免固定 TAPP 治療腹股溝疝的臨床應用(附 60 例報道). 中國普外基礎與臨床雜志, 2015, 22(1): 109-110.
12. 陳思夢, 劉力嘉. 腹股溝疝術后感染及慢性疼痛臨床處理. 中國實用外科雜志, 2014, 35(5): 398-400.
13. Burgmans JP, Voorbrood CE, Van Dalen T, et al. Chronic pain after TEP inguinal hernia repair, does MRI reveal a cause? Hernia, 2016, 20(1): 55-62.
14. Schopf S, von Ahnen T, von Ahnen M, et al. Chronic pain after laparoscopic transabdominal preperitoneal hernia repair: a randomized comparison of light and extralight titanized polypropylene mesh. World J Surg, 2011, 35(2): 302-310.
15. Li W, Sun D, Sun Y, et al. The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation. Surg Endosc, 2017, 31(10): 4238-4243.
16. Pommergaard HC, Burcharth J, Andresen K, et al. No difference in sexual dysfunction after transabdominal preperitoneal (TAPP) approach for inguinal hernia with fibrin sealant or tacks for mesh fixation. Surg Endosc, 2017, 31(2): 661-666.
17. 朱松, 侯克柱, 劉偉, 等. 腹腔鏡經腹腹膜前疝修補術使用免釘合 3D 補片治療老年腹股溝疝的體會. 腹腔鏡外科雜志, 2016, 21(2): 102-104.
18. 黨晨珀, 江道振, 劉晟, 等. 比較經腹腹膜前腹股溝疝修補術中應用 3D 免釘合補片與普通平片的臨床隨機對照試驗. 腹腔鏡外科雜志, 2015, 20(7): 543-546.
19. 曹景新. 免釘合補片腹腔鏡經腹腔腹膜前疝修補術治療腹股溝疝應用觀察. 中國普通外科雜志, 2012, 21(7): 908-910.
20. Sun P, Cheng X, Deng S, et al. Mesh fixation with glue versus suture for chronic pain and recurrence in Lichtenstein inguinal hernioplasty. Cochrane Database Syst Rev, 2017, 2: CD010814.
21. 孟令勤, 楊福全. 腹股溝疝無張力修補術后慢性疼痛治療研究. 中國實用外科雜志, 2014, 34(5): 419-421.
22. Niebuhr H, Wegner F, Hukauf M, et al. What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20, 004 patients from the Herniamed Registry. Surg Endosc, 2018, 32(4): 1971-1983.
23. Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res, 2018, 11: 675-681.
24. 劉斌, 陳金輝. Lichtenstein無張力疝修補術中腹股溝區神經處理的體會. 中國普外基礎與臨床雜志, 2012, 19(3): 314-318.
25. Chatzimavroudis G, Kalaitzis S, Voloudakis N, et al. Evaluation of four mesh fixation methods in an experimental model of ventral hernia repair. J Surg Res, 2017, 212: 253-259.

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Clinical characteristics and risk factors of chronic pain after laparoscopic inguinal hernia repair

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