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Erschienen in: Langenbeck's Archives of Surgery 8/2012

01.12.2012 | Original Article

Chronic pain after open inguinal hernia surgery: suture fixation versus self-adhesive mesh repair

verfasst von: A. J. Quyn, K. M. Weatherhead, T. Daniel

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 8/2012

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Abstract

Purpose

Chronic pain following inguinal hernia repair is a complex problem. Mesh fixation with sutures may be a contributing factor to this pain. The aim of this study was to compare the incidence of chronic pain and limitation of activities of daily living following inguinal hernia repair using a sutured mesh to a self-adhesive mesh, 6 months and 1 year following surgery.

Methods

All consecutive patients presenting to NHS Fife for open hernia repair between January 2009 and January 2010 were included in our analysis. A prospective survey of postoperative pain and activities of daily living was conducted at 6 months and 1 year following hernia repair. Chronic pain was assessed using the SF-36 questionnaire. The primary end points for analysis were incidence of chronic pain and limitation of activities of daily living.

Results

Overall, 132 of 215 patients completed the questionnaire, 69 in the sutured group and 63 in the self-adhesive mesh group. The need for analgesics was similar during the first 24 h after surgery. Wound infections were detected in one patient in the Lichtenstein group and two in the second group. The incidence of chronic pain was 21 and 7.9 % at 6 months and 18.8 and 6.3 % at 1 year (p < 0.05). Moderate and vigorous activities were found to be limited some to all of the time in nine patients (60 %) in the suture fixation group and in one patient in the self-adhesive group (20 %, p < 0.02).

Conclusions

Open inguinal hernia repair with a self-adhesive mesh may lead to less chronic pain and less restriction of activities of daily living than a sutured mesh fixation.
Literatur
1.
Zurück zum Zitat Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518PubMedCrossRef Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518PubMedCrossRef
2.
Zurück zum Zitat Wijsmuller AR, van Veen RN, Bosch JL, Lange JF, Kleinrensink GJ, Jeekel J (2007) Nerve management during open hernia repair. Br J Surg 94:17–22PubMedCrossRef Wijsmuller AR, van Veen RN, Bosch JL, Lange JF, Kleinrensink GJ, Jeekel J (2007) Nerve management during open hernia repair. Br J Surg 94:17–22PubMedCrossRef
3.
Zurück zum Zitat Reinpold WM, Nehls J, Eggert A Nerve management and chronic pain after open inguinal hernia repair: a prospective two phase study. Ann Surg 254:163-168 Reinpold WM, Nehls J, Eggert A Nerve management and chronic pain after open inguinal hernia repair: a prospective two phase study. Ann Surg 254:163-168
4.
Zurück zum Zitat Di Vita G, Milano S, Frazzetta M, Patti R, Palazzolo V, Barbera C, Ferlazzo V, Leo P, Cillari E (2000) Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh. Am J Surg 180:203–207PubMedCrossRef Di Vita G, Milano S, Frazzetta M, Patti R, Palazzolo V, Barbera C, Ferlazzo V, Leo P, Cillari E (2000) Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh. Am J Surg 180:203–207PubMedCrossRef
5.
Zurück zum Zitat Nahabedian MY, Dellon AL (1997) Outcome of the operative management of nerve injuries in the ilioinguinal region. J Am Coll Surg 184:265–268PubMed Nahabedian MY, Dellon AL (1997) Outcome of the operative management of nerve injuries in the ilioinguinal region. J Am Coll Surg 184:265–268PubMed
6.
Zurück zum Zitat Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193PubMedCrossRef Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193PubMedCrossRef
7.
Zurück zum Zitat Amid PK, Shulman AG, Lichtenstein IL (1996) Open "tension-free" repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447–453PubMed Amid PK, Shulman AG, Lichtenstein IL (1996) Open "tension-free" repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447–453PubMed
8.
Zurück zum Zitat Paajanen H (2002) Do absorbable mesh sutures cause less chronic pain than nonabsorbable sutures after Lichtenstein inguinal herniorraphy? Hernia 6:26–28PubMedCrossRef Paajanen H (2002) Do absorbable mesh sutures cause less chronic pain than nonabsorbable sutures after Lichtenstein inguinal herniorraphy? Hernia 6:26–28PubMedCrossRef
9.
Zurück zum Zitat Canonico S, Santoriello A, Campitiello F, Fattopace A, Corte AD, Sordelli I, Benevento R (2005) Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report. Hernia 9:330–333PubMedCrossRef Canonico S, Santoriello A, Campitiello F, Fattopace A, Corte AD, Sordelli I, Benevento R (2005) Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report. Hernia 9:330–333PubMedCrossRef
10.
Zurück zum Zitat Campanelli G, Champault G, Pascual MH, Hoeferlin A, Kingsnorth A, Rosenberg J, Miserez M (2008) Randomized, controlled, blinded trial of Tissucol/Tisseel for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: rationale and study design of the TIMELI trial. Hernia 12:159–165PubMedCrossRef Campanelli G, Champault G, Pascual MH, Hoeferlin A, Kingsnorth A, Rosenberg J, Miserez M (2008) Randomized, controlled, blinded trial of Tissucol/Tisseel for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: rationale and study design of the TIMELI trial. Hernia 12:159–165PubMedCrossRef
11.
Zurück zum Zitat Kapischke M, Schulze H, Caliebe A Self-fixating mesh for the Lichtenstein procedure—a prestudy. Langenbecks Arch Surg 395:317-322 Kapischke M, Schulze H, Caliebe A Self-fixating mesh for the Lichtenstein procedure—a prestudy. Langenbecks Arch Surg 395:317-322
12.
Zurück zum Zitat Anonymous (1986) Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl 3:S1–226 Anonymous (1986) Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl 3:S1–226
13.
Zurück zum Zitat Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11(2):113–6 Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11(2):113–6
14.
Zurück zum Zitat Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48PubMedCrossRef Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48PubMedCrossRef
15.
Zurück zum Zitat Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Fellander G, Heikkinen T (2005) One year results of a randomised controlled multi-centre study comparing Prolene and Vypro II-mesh in Lichtenstein hernioplasty. Hernia 9:223–227PubMedCrossRef Bringman S, Wollert S, Osterberg J, Smedberg S, Granlund H, Fellander G, Heikkinen T (2005) One year results of a randomised controlled multi-centre study comparing Prolene and Vypro II-mesh in Lichtenstein hernioplasty. Hernia 9:223–227PubMedCrossRef
16.
Zurück zum Zitat Paajanen H (2007) A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia. Hernia 11:335–339PubMedCrossRef Paajanen H (2007) A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia. Hernia 11:335–339PubMedCrossRef
17.
Zurück zum Zitat Shulman AG, Amid PK, Lichtenstein IL (1992) The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg 58:255–257PubMed Shulman AG, Amid PK, Lichtenstein IL (1992) The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg 58:255–257PubMed
18.
Zurück zum Zitat van Hanswijck de Jonge P, Lloyd A, Horsfall L, Tan R, O'Dwyer PJ (2008) The measurement of chronic pain and health-related quality of life following inguinal hernia repair: a review of the literature. Hernia 12:561–569PubMedCrossRef van Hanswijck de Jonge P, Lloyd A, Horsfall L, Tan R, O'Dwyer PJ (2008) The measurement of chronic pain and health-related quality of life following inguinal hernia repair: a review of the literature. Hernia 12:561–569PubMedCrossRef
19.
Zurück zum Zitat Ferzli GS, Edwards ED, Khoury GE (2007) Chronic pain after inguinal herniorrhaphy. J Am Coll Surg 205:333–341PubMedCrossRef Ferzli GS, Edwards ED, Khoury GE (2007) Chronic pain after inguinal herniorrhaphy. J Am Coll Surg 205:333–341PubMedCrossRef
20.
Zurück zum Zitat Staal E, Nienhuijs SW, Keemers-Gels ME, Rosman C, Strobbe LJ (2008) The impact of pain on daily activities following open mesh inguinal hernia repair. Hernia 12:153–157PubMedCrossRef Staal E, Nienhuijs SW, Keemers-Gels ME, Rosman C, Strobbe LJ (2008) The impact of pain on daily activities following open mesh inguinal hernia repair. Hernia 12:153–157PubMedCrossRef
21.
Zurück zum Zitat Grant AM, Scott NW, O'Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574PubMedCrossRef Grant AM, Scott NW, O'Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574PubMedCrossRef
22.
Zurück zum Zitat Aasvang EK, Bay-Nielsen M, Kehlet H (2006) Pain and functional impairment 6years after inguinal herniorrhaphy. Hernia 10:316–321PubMedCrossRef Aasvang EK, Bay-Nielsen M, Kehlet H (2006) Pain and functional impairment 6years after inguinal herniorrhaphy. Hernia 10:316–321PubMedCrossRef
23.
Zurück zum Zitat Callesen T, Bech K, Kehlet H (1999) Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528–1531PubMedCrossRef Callesen T, Bech K, Kehlet H (1999) Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528–1531PubMedCrossRef
24.
Zurück zum Zitat Dittrick GW, Ridl K, Kuhn JA, McCarty TM (2004) Routine ilioinguinal nerve excision in inguinal hernia repairs. Am J Surg 188:736–740PubMedCrossRef Dittrick GW, Ridl K, Kuhn JA, McCarty TM (2004) Routine ilioinguinal nerve excision in inguinal hernia repairs. Am J Surg 188:736–740PubMedCrossRef
25.
Zurück zum Zitat Mui WL, Ng CS, Fung TM, Cheung FK, Wong CM, Ma TH, Bn MY, Ng EK (2006) Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial. Ann Surg 244:27–33PubMedCrossRef Mui WL, Ng CS, Fung TM, Cheung FK, Wong CM, Ma TH, Bn MY, Ng EK (2006) Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial. Ann Surg 244:27–33PubMedCrossRef
26.
Zurück zum Zitat Bartlett DC, Porter C, Kingsnorth AN (2007) A pragmatic approach to cutaneous nerve division during open inguinal hernia repair. Hernia 11:243–246PubMedCrossRef Bartlett DC, Porter C, Kingsnorth AN (2007) A pragmatic approach to cutaneous nerve division during open inguinal hernia repair. Hernia 11:243–246PubMedCrossRef
27.
Zurück zum Zitat Picchio M, Palimento D, Attanasio U, Matarazzo PF, Bambini C, Caliendo A (2004) Randomized controlled trial of preservation or elective division of ilioinguinal nerve on open inguinal hernia repair with polypropylene mesh. Arch Surg 139:755–758, discussion 759PubMedCrossRef Picchio M, Palimento D, Attanasio U, Matarazzo PF, Bambini C, Caliendo A (2004) Randomized controlled trial of preservation or elective division of ilioinguinal nerve on open inguinal hernia repair with polypropylene mesh. Arch Surg 139:755–758, discussion 759PubMedCrossRef
28.
Zurück zum Zitat Weyhe D, Belyaev O, Muller C, Meurer K, Bauer KH, Papapostolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of light meshes—a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244PubMedCrossRef Weyhe D, Belyaev O, Muller C, Meurer K, Bauer KH, Papapostolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of light meshes—a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244PubMedCrossRef
29.
Zurück zum Zitat Mills IW, McDermott IM, Ratliff DA (1998) Prospective randomized controlled trial to compare skin staples and polypropylene for securing the mesh in inguinal hernia repair. Br J Surg 85:790–792PubMedCrossRef Mills IW, McDermott IM, Ratliff DA (1998) Prospective randomized controlled trial to compare skin staples and polypropylene for securing the mesh in inguinal hernia repair. Br J Surg 85:790–792PubMedCrossRef
30.
Zurück zum Zitat Paajanen H, Kossi J, Silvasti S, Hulmi T, Hakala T Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg 98:1245-1251 Paajanen H, Kossi J, Silvasti S, Hulmi T, Hakala T Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg 98:1245-1251
31.
Zurück zum Zitat Wong JU, Leung TH, Huang CC, Huang CS Comparing chronic pain between fibrin sealant and suture fixation for bilayer polypropylene mesh inguinal hernioplasty: a randomized clinical trial. Am J Surg 202:34-38 Wong JU, Leung TH, Huang CC, Huang CS Comparing chronic pain between fibrin sealant and suture fixation for bilayer polypropylene mesh inguinal hernioplasty: a randomized clinical trial. Am J Surg 202:34-38
32.
Zurück zum Zitat Chastan P (2009) Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh. Hernia 13:137–142PubMedCrossRef Chastan P (2009) Tension-free open hernia repair using an innovative self-gripping semi-resorbable mesh. Hernia 13:137–142PubMedCrossRef
33.
Zurück zum Zitat Pedano N, Pastor C, Arredondo J, Poveda I, Ruiz J, Monton S, Molina M, Hernandez-Lizoain JL (2012) Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions. Langenbecks Arch Surg 397:291–295PubMedCrossRef Pedano N, Pastor C, Arredondo J, Poveda I, Ruiz J, Monton S, Molina M, Hernandez-Lizoain JL (2012) Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions. Langenbecks Arch Surg 397:291–295PubMedCrossRef
34.
Zurück zum Zitat Anadol AZ, Akin M, Kurukahvecioglu O, Tezel E, Ersoy E A prospective comparative study of the efficacy of conventional Lichtenstein versus self-adhesive mesh repair for inguinal hernia. Surg Today 41:1498-1503 Anadol AZ, Akin M, Kurukahvecioglu O, Tezel E, Ersoy E A prospective comparative study of the efficacy of conventional Lichtenstein versus self-adhesive mesh repair for inguinal hernia. Surg Today 41:1498-1503
35.
Zurück zum Zitat Champault G, Torcivia A, Paolino L, Chaddad W, Lacaine F, Barrat C A self-adhering mesh for inguinal hernia repair: preliminary results of a prospective, multicenter study. Hernia 15:635-641 Champault G, Torcivia A, Paolino L, Chaddad W, Lacaine F, Barrat C A self-adhering mesh for inguinal hernia repair: preliminary results of a prospective, multicenter study. Hernia 15:635-641
Metadaten
Titel
Chronic pain after open inguinal hernia surgery: suture fixation versus self-adhesive mesh repair
verfasst von
A. J. Quyn
K. M. Weatherhead
T. Daniel
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 8/2012
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-012-0949-1

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