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2017, Number 1

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Correo Científico Médico 2017; 21 (1)

Resection of inguinal nerves versus simple section to prevent postoperative pain in hernioplasty with prosthesis

Gámez RJC, Durán RY, Figueredo RY

Language: Spanish
References: 28
Page: 87-99
PDF size: 552.01 Kb.


ABSTRACT

Introduction: The incidence of chronic pain in patients undergoing prosthetic hernioplasty is approximately 10%. Considering as chronic inguinodinea the one that lasts three months or more. The best known cause is neuropathic and multiple strategies are proposed for its treatment.
Objetive: Compare two techniques of neurectomy to prevent postoperative pain in prosthetic hernioplasty.
Method: one hundred seventy five patients, who had underwent inguinal prosthetic hernioplasty between April 2011 and May 2013 were included; to compare two techniques. Resection of 5-10 cm of the nerve was done to 100 patients and to 75 cases simple section or minimal resection (1 cm).
Results: in group 1, at two weeks, 61% of the patients reported moderate pain, only one with severe pain. One month later, 14% showed moderate pain, and one with severe pain. One year later only one patient reported moderate pain. In group 2, at two weeks, 62.7% reported moderate pain and nine (12%) reported severe pain. One month, 44% reported moderate pain and 8 (10.7%) continued with severe pain. One year later, eight (10.7%) reflected with constant moderate pain and of these one patient was re-entered for surgical treatment. The low incidence of chronic pain after neurectomy was significant (1% vs. 10.7%, p = 0.012); the incidence of intense pain in the short and medium term, as well as, moderate pain per month was also lower.
Conclusion: prophylactic resection of the nerve was more effective than the simple section to avoid postoperative pain.


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