Efficacy of retroperitoneal triple neurectomy for refractory neuropathic inguinodynia
(2016) In The American Journal of Surgery 212(6). p.1126-1132- Abstract
BACKGROUND: Refractory neuropathic inguinodynia following inguinal herniorrhaphy is a common and debilitating complication. This prospective study evaluated long-term outcomes associated with laparoscopic retroperitoneal triple neurectomy.
METHODS: Sixty-two consecutive patients (51 male; mean age, 47); all failing pain management; prior reoperation in 35, prior neurectomy in 26; average follow-up 681 days (range: 90 days to 3 years). Measured outcomes include numeric pain ratings, dermatomal mapping, histologic confirmation, quantitative sensory testing, complications, narcotic usage, and activity level.
RESULTS: Mean numerical pain scores were significantly decreased (baseline, 8.6) at all postoperative time points (POD 1,... (More)
BACKGROUND: Refractory neuropathic inguinodynia following inguinal herniorrhaphy is a common and debilitating complication. This prospective study evaluated long-term outcomes associated with laparoscopic retroperitoneal triple neurectomy.
METHODS: Sixty-two consecutive patients (51 male; mean age, 47); all failing pain management; prior reoperation in 35, prior neurectomy in 26; average follow-up 681 days (range: 90 days to 3 years). Measured outcomes include numeric pain ratings, dermatomal mapping, histologic confirmation, quantitative sensory testing, complications, narcotic usage, and activity level.
RESULTS: Mean numerical pain scores were significantly decreased (baseline, 8.6) at all postoperative time points (POD 1, 3.6; P < .001: POD 90, 2.3, P < .001) with durable efficacy from POD 90 to 3 years (P < .001). Quantitative sensory testing showed marked group-level increases of sensory thresholds. Narcotic dependence decreased in 57/62 and was eliminated in 44/62 and activity level improved in 58/62.
CONCLUSIONS: Retroperitoneal triple neurectomy is an effective and durable treatment for refractory neuropathic inguinodynia.
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- author
- Moore, Alexandra M ; Bjurstrom, Martin F ; Hiatt, Jonathan R ; Amid, Parviz K and Chen, David C
- publishing date
- 2016-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Aged, Denervation, Female, Hernia, Inguinal, Herniorrhaphy, Humans, Laparoscopy, Male, Middle Aged, Neuralgia, Pain, Postoperative, Prospective Studies, Treatment Outcome, Young Adult, Journal Article
- in
- The American Journal of Surgery
- volume
- 212
- issue
- 6
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:27771034
- scopus:84999289093
- ISSN
- 1879-1883
- DOI
- 10.1016/j.amjsurg.2016.09.012
- language
- English
- LU publication?
- no
- id
- 6b25bd4e-cc91-4175-bb5d-03a0483e996b
- date added to LUP
- 2018-04-26 10:32:04
- date last changed
- 2024-06-11 14:34:20
@article{6b25bd4e-cc91-4175-bb5d-03a0483e996b,
abstract = {{<p>BACKGROUND: Refractory neuropathic inguinodynia following inguinal herniorrhaphy is a common and debilitating complication. This prospective study evaluated long-term outcomes associated with laparoscopic retroperitoneal triple neurectomy.</p><p>METHODS: Sixty-two consecutive patients (51 male; mean age, 47); all failing pain management; prior reoperation in 35, prior neurectomy in 26; average follow-up 681 days (range: 90 days to 3 years). Measured outcomes include numeric pain ratings, dermatomal mapping, histologic confirmation, quantitative sensory testing, complications, narcotic usage, and activity level.</p><p>RESULTS: Mean numerical pain scores were significantly decreased (baseline, 8.6) at all postoperative time points (POD 1, 3.6; P < .001: POD 90, 2.3, P < .001) with durable efficacy from POD 90 to 3 years (P < .001). Quantitative sensory testing showed marked group-level increases of sensory thresholds. Narcotic dependence decreased in 57/62 and was eliminated in 44/62 and activity level improved in 58/62.</p><p>CONCLUSIONS: Retroperitoneal triple neurectomy is an effective and durable treatment for refractory neuropathic inguinodynia.</p>}},
author = {{Moore, Alexandra M and Bjurstrom, Martin F and Hiatt, Jonathan R and Amid, Parviz K and Chen, David C}},
issn = {{1879-1883}},
keywords = {{Adult; Aged; Denervation; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Laparoscopy; Male; Middle Aged; Neuralgia; Pain, Postoperative; Prospective Studies; Treatment Outcome; Young Adult; Journal Article}},
language = {{eng}},
number = {{6}},
pages = {{1126--1132}},
publisher = {{Elsevier}},
series = {{The American Journal of Surgery}},
title = {{Efficacy of retroperitoneal triple neurectomy for refractory neuropathic inguinodynia}},
url = {{http://dx.doi.org/10.1016/j.amjsurg.2016.09.012}},
doi = {{10.1016/j.amjsurg.2016.09.012}},
volume = {{212}},
year = {{2016}},
}