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The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Jun2024, Vol. 38 Issue 6, p3433-3440, 8p
- Publication Year :
- 2024
-
Abstract
- Introduction: Fixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up. Methods: This is a post hoc analysis of a randomized controlled trial in patients undergoing laparoscopic inguinal hernia repair (NCT03835351). All patients were contacted at maximum follow-up after surgery to administer EuraHS quality of life (QoL) surveys. The pain and restriction of activity subdomains of the survey were utilized. The primary outcome was rate of CGP, as defined by a EuraHS QoL pain domain score ≥ 4 measured at ≥ 1 year postoperatively. The secondary outcomes were pain and restriction of activity domain scores and hernia recurrence at maximum follow-up. Results: A total of 338 patients were contacted at a mean follow-up of 28 ± 11 months. 181 patients received permanent tacks and 157 patients received absorbable tacks during their repair. At maximum follow-up, the rates of CGP (27 [15%] vs 28 [18%], P = 0.47), average pain scores (1.78 ± 4.38 vs 2.32 ± 5.40, P = 0.22), restriction of activity scores (1.39 ± 4.32 vs 2.48 ± 7.45, P = 0.18), and the number of patients who reported an inguinal bulge (18 [9.9%] vs 15 [9.5%], P = 0.9) were similar between patients with permanent versus absorbable tacks. On multivariable analysis, there was no significant difference in the odds of CGP between the two groups (OR 1.23, 95% CI [0.60, 2.50]). Conclusion: Mesh fixation with permanent tacks does not appear to increase the risk of CGP after laparoscopic inguinal hernia repair when compared to fixation with absorbable tacks. Prospective trials are needed to further evaluate this relationship. [ABSTRACT FROM AUTHOR]
- Subjects :
- PROSTHETICS
PAIN measurement
PEARSON correlation (Statistics)
GROIN pain
CHRONIC pain
SURGERY
PATIENTS
DATA analysis
LAPAROSCOPIC surgery
POSTOPERATIVE pain
STATISTICAL sampling
QUESTIONNAIRES
FISHER exact test
LOGISTIC regression analysis
ARTIFICIAL implants
RANDOMIZED controlled trials
DESCRIPTIVE statistics
MULTIVARIATE analysis
MANN Whitney U Test
CHI-squared test
ODDS ratio
INGUINAL hernia
HERNIA surgery
STATISTICS
PAIN management
COMPARATIVE studies
DISEASE relapse
CONFIDENCE intervals
DATA analysis software
HEALTH outcome assessment
SURGICAL meshes
PHYSICAL activity
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 38
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 177510121
- Full Text :
- https://doi.org/10.1007/s00464-024-10866-z