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Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair

Eklund, A.; Montgomery, Agneta LU ; Bergkvist, L. and Rudberg, C. (2010) In British Journal of Surgery 97(4). p.600-608
Abstract
Background: Chronic postoperative pain is a major drawback of inguinal hernia repair. This study compared the frequency of chronic pain after laparoscopic (totally extraperitoneal patch, TEP) and open (Lichtenstein) repairs. Methods: A randomized multicentre study with 5 years' follow-up was conducted on men with a primary inguinal hernia. Chronic pain was categorized as mild, moderate or severe by blinded observers. A subgroup analysis was performed on 121 patients who experienced moderate or severe pain at any time during follow-up. Results: Overall, 1370 of 1512 randomized patients underwent surgery, 665 in the TEP and 705 in the Lichtenstein group. The total incidence of chronic pain was 11.0 versus 21.7 per cent at 1 year, 11.0 versus... (More)
Background: Chronic postoperative pain is a major drawback of inguinal hernia repair. This study compared the frequency of chronic pain after laparoscopic (totally extraperitoneal patch, TEP) and open (Lichtenstein) repairs. Methods: A randomized multicentre study with 5 years' follow-up was conducted on men with a primary inguinal hernia. Chronic pain was categorized as mild, moderate or severe by blinded observers. A subgroup analysis was performed on 121 patients who experienced moderate or severe pain at any time during follow-up. Results: Overall, 1370 of 1512 randomized patients underwent surgery, 665 in the TEP and 705 in the Lichtenstein group. The total incidence of chronic pain was 11.0 versus 21.7 per cent at 1 year, 11.0 versus 24.8 per cent at 2 years, 9.9 versus 20.2 per cent at 3 years and 9.4 versus 18.8 per cent at 5 years in the TEP and Lichtenstein groups respectively (P < 0.001). After 5 years, 1.9 per cent of patients in the TEP and 3.5 per cent in the Lichtenstein group reported moderate or severe pain (P = 0.092). Of the 121 patients, 72 (59.5 per cent) no longer reported pain a median of 9.4 (range 6.7-10.8) years after operation. Conclusion: Five years after surgery only a small proportion of patients still report moderate to severe chronic pain. Laparoscopic inguinal hernia repair leads to less chronic pain than open repair. Registration number: NCT00568269 (http://www.clinicaltrials.gov). (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
97
issue
4
pages
600 - 608
publisher
John Wiley & Sons
external identifiers
  • wos:000276375400022
  • scopus:77949373264
ISSN
1365-2168
DOI
10.1002/bjs.6904
language
English
LU publication?
yes
id
9aa8c5f7-7796-43d6-877a-32f9731fad1a (old id 1603963)
date added to LUP
2010-05-18 15:53:57
date last changed
2018-05-29 12:03:53
@article{9aa8c5f7-7796-43d6-877a-32f9731fad1a,
  abstract     = {Background: Chronic postoperative pain is a major drawback of inguinal hernia repair. This study compared the frequency of chronic pain after laparoscopic (totally extraperitoneal patch, TEP) and open (Lichtenstein) repairs. Methods: A randomized multicentre study with 5 years' follow-up was conducted on men with a primary inguinal hernia. Chronic pain was categorized as mild, moderate or severe by blinded observers. A subgroup analysis was performed on 121 patients who experienced moderate or severe pain at any time during follow-up. Results: Overall, 1370 of 1512 randomized patients underwent surgery, 665 in the TEP and 705 in the Lichtenstein group. The total incidence of chronic pain was 11.0 versus 21.7 per cent at 1 year, 11.0 versus 24.8 per cent at 2 years, 9.9 versus 20.2 per cent at 3 years and 9.4 versus 18.8 per cent at 5 years in the TEP and Lichtenstein groups respectively (P &lt; 0.001). After 5 years, 1.9 per cent of patients in the TEP and 3.5 per cent in the Lichtenstein group reported moderate or severe pain (P = 0.092). Of the 121 patients, 72 (59.5 per cent) no longer reported pain a median of 9.4 (range 6.7-10.8) years after operation. Conclusion: Five years after surgery only a small proportion of patients still report moderate to severe chronic pain. Laparoscopic inguinal hernia repair leads to less chronic pain than open repair. Registration number: NCT00568269 (http://www.clinicaltrials.gov).},
  author       = {Eklund, A. and Montgomery, Agneta and Bergkvist, L. and Rudberg, C.},
  issn         = {1365-2168},
  language     = {eng},
  number       = {4},
  pages        = {600--608},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair},
  url          = {http://dx.doi.org/10.1002/bjs.6904},
  volume       = {97},
  year         = {2010},
}