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01-12-2023 | Inguinal Hernia | Research

Intraneural fibrosis within ilioinguinal nerve in inguinal hernia patients with preoperative pain: it’s the sign of irreversible nerve injury, isn’t it?

Authors: Masato Narita, Koki Moriyoshi, Ryoya Yamaoka, Masaaki Moriyama, Kanako Degawa, Masashi Fushitani, Hiroya Kojima, Takahiro Suenaga, Hiroki Nakanishi, Gen Nishikawa, Yasutaka Nakanishi, Hiroaki Hata

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Purpose

Preoperative pain is known as one of the most powerful risk factors for chronic postoperative inguinal pain (CPIP), while its pathogenesis has not been fully elucidated. The aim of the present study was to evaluate patients with preoperative pain from the pathological perspective and discuss the potential pathogenesis of CPIP in those patients.

Methods

This was a single-institutional retrospective study. The study population was inguinal hernia patients with preoperative pain who underwent open anterior hernia repair for primary inguinal hernia with pragmatic ilioinguinal neurectomy during surgery between March 2021 and March 2023. The primary and secondary outcomes were proportion of collagen deposition and mucus accumulation within ilioinguinal nerve in those patients, respectively, which were evaluated histologically using Image J software.

Results

Forty patients were evaluated. Median value of proportion of intraneural collagen deposition was 38.3% (27.7–95.9). These values were positively correlated with the duration of pain (r²=0.468, P<0.001). Median value of proportion of mucus accumulation in ilioinguinal nerve was 50.1% (0–82.0). These values had no correlation with any clinicopathological variables.

Conclusions

In the present study population, all patients with preoperative pain had intraneural fibrosis within ilioinguinal nerve, and its degree had a positive correlation with the pain duration.

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Title: Intraneural fibrosis within ilioinguinal nerve in inguinal hernia patients with preoperative pain: it’s the sign of irreversible nerve injury, isn’t it?
Authors: Masato Narita
Koki Moriyoshi
Ryoya Yamaoka
Masaaki Moriyama
Kanako Degawa
Masashi Fushitani
Hiroya Kojima
Takahiro Suenaga
Hiroki Nakanishi
Gen Nishikawa
Yasutaka Nakanishi
Hiroaki Hata
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Inguinal Hernia
Nerve Injury
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03158-y

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Intraneural fibrosis within ilioinguinal nerve in inguinal hernia patients with preoperative pain: it’s the sign of irreversible nerve injury, isn’t it?

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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