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Efficacy of retroperitoneal triple neurectomy for refractory neuropathic inguinodynia

Moore, Alexandra M; Bjurstrom, Martin F; Hiatt, Jonathan R; Amid, Parviz K and Chen, David C (2016) In 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
publishing date
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
American Journal of Surgery
volume
212
issue
6
pages
7 pages
publisher
Elsevier
external identifiers
  • 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
2018-05-29 11:00:18
@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 &lt; .001: POD 90, 2.3, P &lt; .001) with durable efficacy from POD 90 to 3 years (P &lt; .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},
  keyword      = {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       = {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},
  volume       = {212},
  year         = {2016},
}