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World Journal of Surgery
Published in: World Journal of Surgery 11/2015

01-11-2015 | Original Scientific Report

Factors Determining Outcome After Surgery for Chronic Groin Pain Following a Lichtenstein Hernia Repair

Authors: Willem A. R. Zwaans, Tim Verhagen, Rudi M. H. Roumen, Marc R. M. Scheltinga

Published in: World Journal of Surgery | Issue 11/2015

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Abstract

Background

Some patients develop chronic groin pain after a Lichtenstein hernia repair. Previous studies have demonstrated beneficial effects of removal of entrapped inguinal nerves or a meshectomy in patients with chronic pain after open inguinal hernia mesh repair. Factors determining success following this remedial surgery are unknown. The aim of the study was to identify potential patient- or surgery-related factors predicting the surgical efficacy for inguinodynia following Lichtenstein repair.

Methods

Consecutive adult patients with a history of persistent pain following Lichtenstein repair who underwent remedial surgery were analysed using univariate analysis. Significant confounders (p < 0.05) were combined in a multivariate logistic regression model using a backward stepwise regression method.

Results

A total of 136 groin pain operations were available for analysis. Factors contributing to success were removal of a meshoma (OR 4.66) or a neuroma (OR 5.60) and the use of spinal anaesthesia (OR 4.38). In contrast, female gender (OR 0.30) and preoperative opioid use (OR 0.38) were significantly associated with a less favourable outcome. Using a multivariate analysis model, surgery under spinal anaesthesia (OR 4.04), preoperative use of opioids (OR 0.37), and meshoma removal (OR 5.31) greatly determined surgical outcome.

Conclusions

Pain reduction after remedial surgery for chronic groin pain after Lichtenstein repair is more successful if surgery is performed under spinal anaesthesia compared to general anaesthesia. Removal of a meshoma must be considered as success rates are optimized following these measures. Patients using opioids preoperatively have less favourable outcomes.
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Metadata
Title
Factors Determining Outcome After Surgery for Chronic Groin Pain Following a Lichtenstein Hernia Repair
Authors
Willem A. R. Zwaans
Tim Verhagen
Rudi M. H. Roumen
Marc R. M. Scheltinga
Publication date
01-11-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3183-5

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