Abstract
Background
Improved recurrence rates after groin hernia surgery have led to chronic pain becoming
the most troublesome postoperative complication. Self-gripping mesh was developed
to decrease the risk for development of chronic pain. The aim of this nationwide cohort
study was to compare recurrence rate and chronic pain 1 year after an open, anterior
mesh repair of inguinal hernias with either a self-gripping mesh or other lightweight
mesh.
Method
All operations registered as open anterior mesh repair (Lichtenstein) in the Swedish
Hernia Registry between September 2012 and October 2016 were selected. At 1 year after
repair, patients were sent a pain questionnaire assessing chronic pain. We compared
the prevalence of chronic pain and reoperation for recurrence using lightweight, sutured
mesh or self-gripping mesh.
Results
We analyzed the 1,803 repairs using self-gripping mesh and 16,567 repairs using lightweight
mesh. We found no difference in the prevalence of chronic pain 1 year after the hernia
repair between self-gripping mesh and sutured lightweight mesh (OR 0.92, CI 95% 0.80–1.06,
P = .257). There was no increase in reoperation for recurrence when using self-gripping
mesh (HR 0.71, CI 95% 0.45–1.14, P = .156). Mean operation time was considerably less when using self-gripping mesh
(43 vs 70 minutes; P > .001).
Conclusion
The use of self-gripping mesh does not decrease the incidence of chronic pain and
reoperation for recurrence compared with lightweight, sutured mesh for open anterior
mesh repair of inguinal hernias. Furthermore, the use of self-gripping mesh is associated
with a clinically important, lesser operation time.
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Article info
Publication history
Published online: December 12, 2019
Accepted:
November 11,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Re: Chronic pain and risk for reoperation for recurrence after inguinal hernia repair using self-gripping meshSurgeryVol. 169Issue 5
- PreviewWe read with interest the report by Axman et al1 entitled “Chronic pain and risk for reoperation for recurrence after inguinal hernia using self-gripping mesh.” We found this subject relevant because chronic pain after inguinal hernia repair remains one of the main postoperative complications than can cause chronic distress to patients. The authors reported a rate of 15% of patients with chronic pain after inguinal hernia repair, and although in their methods section they reported to have recorded how the surgeon handled the nerves, these data were not published.
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