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J Coll Physicians Surg Pak · Sep 2020
Randomized Controlled TrialNeurectomy versus Nerve Sparing in Open Inguinal Hernia Repair: A Randomised Controlled Trial.
- Shabbar Hussain Changazi, Nafeesah Fatimah, Asif Naseer, Abdul Wadood, Qamar Ashfaq Ahmad, and Mahmood Ayyaz.
- Department of General Surgery, Services Hospital, Lahore, Pakistan.
- J Coll Physicians Surg Pak. 2020 Sep 1; 30 (9): 917-920.
Objective To determine the effect of neurectomy in reducing the frequency of chronic inguinodynia after mesh hernioplasty in open inguinal hernia repair.Study DesignSingle blind randomised controlled-trial.Place And Duration Of StudySurgical Unit-I, Department of General Surgery, Services Hospital, Lahore, Pakistan from September 2018 to September 2019.MethodologyAll male patients undergoing open groin hernia surgery were included in the study. A total of 100 patients were randomly categorised into group A (neurectomy group) and group B (nerve sparing group). Patients were followed up for three months for the development of chronic inguinodynia. Signifiance was determined at p <0.05 using Chi-square and Fisher's exact tests.ResultsOut of 100 patients, 50 patients were enrolled in group A, while 50 were enrolled in group B. Mean age of patients was 42.1 ± 17.5 years. The median (IQR) acute pain score in neurectomy group was 3.0 (2.0-4.0), while median (IQR) acute pain score was 4.0 (3.0-6.0) in nerve sparing group with statistically significant difference (z = -3.256, p = 0.001). The frequency of chronic inguinodynia was significantly less in group A compared to group B [3 (6%) vs. 13 (26%), p = 0.012].ConclusionExcision of ilioinguinal and iliohypogastric nerve in inguinal mesh hernioplasty reduces the frequency of chronic inguinodynia. Ilioinguinal neurectomy may be practised routinely in patients undergoing Lichtenstein mesh hernioplasty. Key Words: Inguinal neurectomy, Inguinal hernia, Chronic inguinodynia, Lichtenstein mesh hernioplasty.
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