Niranjana, B (2019) Comparison between Preservation of Ilioinguinal Nerve Versus Ilioinguinal Neurectomy during Elective Inguinal Hernioplasty in Preventing Inguinodynia. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
BACKGROUND: While the recurrence rate of inguinal hernia repairs is significantly reduced by the use of mesh and tension free techniques, post herniorraphy, hernioplasty chronic pain remains the concern for hernia surgeons. Neuropathic pain has a universally reported rate of 5-8% 2. The price for artificial prosthesis has been high with pain ranging from 10% to 50% 3. Elective neurectomy of ilioinguinal nerve can prevent postoperative inguinodynia 4. Groin re-exploration after the patient develops inguinodynia as a separate procedure is difficult because of abundant scar 4. Sensory deprivation in the distribution of these structures is better tolerated by the patient than chronic or persistent pain 4. OBJECTIVES: 1. To assess whether elective ilioinguinal neurectomy during inguinal hernioplasty reduces incidence of postoperative inguinodynia. 2. To assess the difference in morbidity and quality of life between a control group where nerves were preserved and the group undergoing elective ilioinguinal neurectomy. METHODS: 100 patients who underwent inguinal hernioplasty are split into two groups, one control group (50 patients) where the nerves were preserved and the second case group (50 patients) undergoing elective ilioinguinal neurectomy, in Department of General Surgery, Coimbatore medical college hospital. Pain was assessed using visual analog score during the postoperative period, at 3 months and 1 year follow up. RESULTS: There was a statistically significant decrease in pain scores in the postoperative period and at 3 months and 1 year follow up in the neurectomy group. There was no significant differences in analgesic usage during the postoperative period. There was statistically significant decrease in duration of stay in the neurectomy group. There was no subjective experience of loss of sensation, numbness or paresthesia. CONCLUSIONS: Routine ilioinguinal neurectomy during elective hernioplasty can be used to reduce inguinodynia without obvious side effects. Thus, we can prevent patients from suffering from debilitating inguinal pain interfering with the quality of their lives.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.221611307 |
| Uncontrolled Keywords: | Ilioinguinal neurectomy, postoperative inguinodynia, chronic inguinal pain post hernioplasty. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 02 Sep 2019 07:25 |
| Last Modified: | 08 Sep 2019 07:50 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11412 |
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