Simon W Nienhuijs1, Camiel Rosman. 1. Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands, simon.nienhuijs@cze.nl.
Abstract
PURPOSE: To assess long-term superiority in terms of chronic pain between prolene hernia system (PHS), mesh plug repair (MPR) and Lichtenstein (L) technique for inguinal hernia repair. METHODS: Eight years after randomizing three commonly used techniques for primary inguinal hernia repair, the outcome was evaluated with a questionnaire measuring pain on verbal descriptor and visual analogue scales, including limitations on daily life activities, sensory disturbances and recurrences. From previous results patients characteristics, operative details and short- and mid-term pain outcome were extracted. RESULTS: 270 out of 308 eligible patients (88%) completed the follow-up after median 7.6 years (range 6.9-9.2) after the inguinal hernia operation. No significant differences between the repair techniques were found for pain, sensory disturbances or recurrences. Overall, the hernia recurrence rate was 6.3%. In total 63 patients (23%) reported long-term pain of which one-fourth graded this moderate to severe. Pain was experienced at least weekly by 26 patients (10%) and limiting daily activities for 36 patients (13%). With regard to the previously reported pain at 3 and 15 months follow-up, 106 patients (39%) experience no pain at all. For 101 patients (37%), initial pain disappeared. 41 patients (15%) suffered persisting pain at all three measure moments. 22 patients (8%) reported pain at 8 years follow-up after an initial pain-free period. CONCLUSIONS: Long-term outcome after randomizing PHS, MPR and L showed no clinically relevant differences in chronic pain and its consequences. Although chronic pain is diminishing over time it remains a serious complication and has sometimes an onset long after the inguinal repair.
RCT Entities:
PURPOSE: To assess long-term superiority in terms of chronic pain between prolene hernia system (PHS), mesh plug repair (MPR) and Lichtenstein (L) technique for inguinal hernia repair. METHODS: Eight years after randomizing three commonly used techniques for primary inguinal hernia repair, the outcome was evaluated with a questionnaire measuring pain on verbal descriptor and visual analogue scales, including limitations on daily life activities, sensory disturbances and recurrences. From previous results patients characteristics, operative details and short- and mid-term pain outcome were extracted. RESULTS: 270 out of 308 eligible patients (88%) completed the follow-up after median 7.6 years (range 6.9-9.2) after the inguinal hernia operation. No significant differences between the repair techniques were found for pain, sensory disturbances or recurrences. Overall, the hernia recurrence rate was 6.3%. In total 63 patients (23%) reported long-term pain of which one-fourth graded this moderate to severe. Pain was experienced at least weekly by 26 patients (10%) and limiting daily activities for 36 patients (13%). With regard to the previously reported pain at 3 and 15 months follow-up, 106 patients (39%) experience no pain at all. For 101 patients (37%), initial pain disappeared. 41 patients (15%) suffered persisting pain at all three measure moments. 22 patients (8%) reported pain at 8 years follow-up after an initial pain-free period. CONCLUSIONS: Long-term outcome after randomizing PHS, MPR and L showed no clinically relevant differences in chronic pain and its consequences. Although chronic pain is diminishing over time it remains a serious complication and has sometimes an onset long after the inguinal repair.
Authors: Raoul A Droeser; Salome Dell-Kuster; Anita Kurmann; Rachel Rosenthal; Markus Zuber; Jürg Metzger; Daniel Oertli; Christian T Hamel; Daniel M Frey Journal: Ann Surg Date: 2014-05 Impact factor: 12.969
Authors: Emanuel N van den Broeke; Lonneke Koeslag; Laura J Arendsen; Simon W Nienhuijs; Camiel Rosman; Clementina M van Rijn; Oliver H G Wilder-Smith; Harry van Goor Journal: PLoS One Date: 2013-12-23 Impact factor: 3.240