Groin切除术治疗非医源性睾丸和Groin疼痛

Sanchit Sachdeva, A. Chhabra, J. Reisch, S. Rozen
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引用次数: 0

摘要

摘要背景 慢性腹股沟神经痛是困扰世界各地患者的一种使人衰弱的疾病。虽然腹股沟神经痛通常可追溯到医源性原因(腹股沟疝修补术、输精管切除术和子宫切除术),但有一组独特的患者表现为非萎缩性腹股沟神经痛。这些患者的诊断和治疗是一个特殊的挑战。方法 2008年至2017年间,共有30名患者(目前平均年龄46.5[范围:19-72]岁)出现非萎缩性腹股沟神经痛,并接受了髂下腹部、髂腹股沟和生殖器股神经的切除术。对术前和术后即刻疼痛评分的回顾性审查与前瞻性收集的Likert评分表(0-10)上的当前疼痛进行了比较。此外,患者被要求填写一份简短表格(SF)-20,并确定当前的止痛药。采用双侧Wilcoxon–Mann–Whitney检验对数据进行分析。后果 在确定的30名患者中,有16名可以参与(平均随访 = 61个月)。整个组的平均疼痛减轻率为62.7%。当使用已确定的30%减轻疼痛作为临床意义的标志时,12名成功和4名不成功的患者的平均疼痛减少率分别为81.1%和7.68%(成功率为75%)。成功组患者的社会功能有统计学意义(p = 0.012),并且心理健康水平几乎显著提高(p = 0.063)。在比较两组时,观察到每隔一个SF-20生活质量(QoL)类别的平均量表得分有所改善,尽管没有显著性。结论 神经切除术是一种潜在的有益手术,可以缓解非萎缩性腹股沟神经痛患者的疼痛,提高生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Groin Neurectomies for Noniatrogenic Testicular and Groin Pain
Abstract Background Chronic groin neuralgia is a life-debilitating condition that plagues patients worldwide. While groin neuralgia is usually traced to iatrogenic causes (inguinal hernia repairs, vasectomy, and hysterectomy), there is a unique subset of patients that present with noniatrogenic groin neuralgia. The diagnosis and treatment of these patients present a particular challenge. Methods A total of 30 patients (current mean age, 46.5 [range: 19–72] years) who presented with noniatrogenic groin neuralgia and received neurectomies on the iliohypogastric, ilioinguinal, and genitofemoral nerves between 2008 and 2017 were identified. A retrospective review of preoperative and immediate postoperative pain scores was compared with prospectively collected current pain on a Likert's scale (0–10). Additionally, patients were asked to complete a Short Form (SF)-20 and identify current pain medications. A two-sided Wilcoxon–Mann–Whitney test was used to analyze the data. Results Of the 30 patients identified, 16 could participate (mean follow-up = 61 months). The average pain reduction for the entire group was 62.7%. When using an established 30% reduction pain as a marker for clinical significance, 12 successful and 4 unsuccessful patients had an average reduction of 81.1 and 7.68%, respectively (success rate of 75%). Patients with successful group showed a statistically significant increased social functioning (p = 0.012) and near-significant increase in mental health (p = 0.063). Improvements, albeit nonsignificant, in mean scaled scores for every other SF-20 quality of life (QoL) category were observed when comparing both groups. Conclusion Neurectomy is a potentially beneficial surgery that can assuage pain and improve quality of life for patients with noniatrogenic groin neuralgia.
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