Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial
- PMID: 16794386
- PMCID: PMC1570605
- DOI: 10.1097/01.sla.0000217691.81562.7e
Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial
Abstract
Objective: We conducted a double-blinded randomized controlled trial to investigate the short- to mid-term neurosensory effect of prophylactic ilioinguinal neurectomy during Lichtenstein repair of inguinal hernia.
Method: One hundred male patients between the age of 18 and 80 years with unilateral inguinal hernia undergoing Lichtenstein hernia repair were randomized to receive either prophylactic ilioinguinal neurectomy (group A) or ilioinguinal nerve preservation (group B) during operation. All operations were performed by surgeons specialized in hernia repair under local anesthesia or general anesthesia. The primary outcome was the incidence of chronic groin pain at 6 months. Secondary outcomes included incidence of groin numbness, postoperative sensory loss or change at the groin region, and quality of life measurement assessed by SF-36 questionnaire at 6 months. All follow-up and outcome measures were carried out by a designated occupational therapist at 1 and 6 months following surgery in a double-blinded manner.
Results: The incidence of chronic groin pain at 6 months was significantly lower in group A than group B (8% vs. 28.6%; P = 0.008). No significant intergroup differences were found regarding the incidence of groin numbness, postoperative sensory loss or changes at the groin region, and quality of life measurement at 6 months after the operation.
Conclusions: Prophylactic ilioinguinal neurectomy significantly decreases the incidence of chronic groin pain after Lichtenstein hernia repair without added morbidities. It should be considered as a routine surgical step during the operation.
Comment in
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Prophylactic ilioinguinal neurectomy in open inguinal hernia repair.Ann Surg. 2007 Apr;245(4):663. doi: 10.1097/01.sla.0000259048.32440.5b. Ann Surg. 2007. PMID: 17414619 Free PMC article. No abstract available.
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Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial.Ann Surg. 2007 Dec;246(6):1116. doi: 10.1097/SLA.0b013e31815c2979. Ann Surg. 2007. PMID: 18043120 No abstract available.
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A meta-analytic approach to ilioinguinal nerve excision or preservation during open inguinal hernia repair.Ann Surg. 2008 Jun;247(6):1078; discussion 1078-80. doi: 10.1097/SLA.0b013e3181758d39. Ann Surg. 2008. PMID: 18520244 No abstract available.
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