EVALUATION OF POSTOPERATIVE PAIN IN PRESERVATION AND ELECTVE DISSECTION OF THE ILIOINGUINAL NERVE IN INGUINAL HERNIOPLASTY

Q4 Medicine
Zanita Jovanovska Spasova, Biljana Todorovska Shapova, Elizabeta Obocki Lukovska, I. Kikerkov, Kristina Pavlovska, Elizabeta Zhogovska, Maja Slaninka Miceska
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Abstract

Introduction: The use of mesh techniques in the treatment of inguinal hernias significantly reduces recurrences. However, the incidence of inguinodynia still present significant complication. Material and methods: The study was designed as a randomized, prospective, unilaterally blind clinical study. Forty male patients were included, to whom hernioplasty by Lichtenstein method with implantation of polypropylene mesh was performed. Patients were divided into 2 groups of twenty patients each. In the first one the technique of the ilioinguinal preservation was used, and in the second one dissection of the ilioinguinal nerve was performed. At appropriate time points two types of scales were used to assess the intensity of the pain: Numeric scale of pain (NSP) and Stanford pain scale (SPS). Results: Data from 40 patients has been analyzed, of which 20 with preservation and 20 with dissection of the ilioinguinal nerve. Inguinodynia was present in two patients, one in each group, i.e. 5%, which indicates that there was no significant difference in the occurrence of inguinodynia in the group with preservation and dissection of the ilioinguinal nerve. Conclusion: No single direction can yet be given as to whether it is better to preserve or dissect the inguinal nerves, and there is also division over whether, if a neurectomy should be performed, it should be limited to the IIN or a triple neurectomy should be performed.
腹股沟疝成形术中保留和选择性剥离髂腹股沟神经术后疼痛的评价
简介:使用补片技术治疗腹股沟疝可显著减少复发。然而,腹股沟痛的发生率仍然存在显著的并发症。材料与方法:本研究设计为随机、前瞻性、单侧盲临床研究。选取40例男性患者,行利希滕斯坦法疝成形术并植入聚丙烯补片。患者分为2组,每组20例。第一例采用髂腹股沟保留术,第二例采用髂腹股沟神经分离术。在适当的时间点,采用数值疼痛量表(numerical scale of pain, NSP)和斯坦福疼痛量表(Stanford pain scale, SPS)评估疼痛强度。结果:分析了40例患者的资料,其中保留髂腹股沟神经20例,剥离髂腹股沟神经20例。2例患者出现腹股沟痛,每组1例,即5%,说明保留和剥离髂腹股沟神经组腹股沟痛的发生率无显著差异。结论:腹股沟神经是保留好还是切除好,目前还没有统一的方向,如果行神经切除术,是局限于IIN还是行三联神经切除术,也存在分歧。
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