Evaluation of chronic pain after transabdominal preperitoneal hernia repair
DOI:
https://doi.org/10.18203/2349-2902.isj20180797Keywords:
Chronic pain, Transabdominal preperitoneal hernia repairAbstract
Background: Early postoperative pain after transabdominal preperitoneal hernia repair (TAPP) has been frequently reported. However, the incidence and degree of chronic pain after TAPP have not been evaluated. Therefore, author aimed to examine chronic pain after TAPP.
Methods: A total of 256 who underwent TAPP between November 2008 and March 2015 at the institute were enrolled. Original questionnaires focusing on the current state of pain were sent to the enrolled patients by mail. The incidence, body location, and degree of chronic pain occurring at least 6 months after the initial surgery were evaluated. In addition, a medical chart review of patients with and without chronic pain was performed to determine the predictive factors of chronic pain.
Results: The survey response rate was 43.8% (112/256). The median follow-up period after the initial surgery was 44.3 months (range, 9.7-80.3 months). Sixty percent of patients experienced pain after TAPP; however, in 56.2% of the patients, the pain had mitigated 1 week after TAPP. Ten percent (12/112) of the patients had chronic pain 6 months after TAPP. Pain in the inguinal region was more frequently reported than any other wound region (67% vs 25%, p =0.0009). Although most of the patients with pain felt the pain occasionally, three of twelve patients (25%) complained of daily pain and had high VAS score. No significant predictive factors of chronic pain were identified.
Conclusions: Ten percent of patients experienced chronic pain after TAPP. Large scale prospective trials are needed to identify the predictive factors of chronic pain.
Metrics
References
Grant AM, Scott NW, O’Dwyer PJ. MRC Laparoscopic Groin Hernia Trial Group. Five-year follow-up of a rasndomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg. 2004;91:1570-4.
Primatesta P, Goldacre MJ. Inguinal hernia repair, incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835-9.
Ger R, Monroe K, Duvivier R. Management of indirect inguinal hernias by laparoscopic closure of the neck of the sac. Am J Surg. 1990;159:370-3.
Arregui ME, Davis CJ, Yucel O. Laparoscopic mesh repair of inguinal hernia using a pre-peritoneal approach: A preliminary report. Surg Laparosc Endosc. 1992;2:53-8.
Dion YM, Morin J. Laparoscopic inguinal herniorrhaphy. Can J Surg. 1992;35:209-12.
Sharma D, Yadav K. Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias. Int J Surg. 2015;22:110-7.
Moldovanu R, Pavy G. Laparoscopic transabdominal pre-peritoneal (TAPP) procedure-step-by-step tips and tricks. Surgical Technique Chirurgia. 2014;109:407-15.
Cawich SO, Mohanty SK, Bonadie KO. Laparoscopic inguinal hernia repair in a developing nation: short-term outcomes in 103 consecutive procedures. J Surg Tech Case Rep. 2013;5:13-7.
Salma U, Ahmed I, Ishtiaq S. A comparison of postoperative pain and hospital stay between Lichtenstein's repair and Laparoscopic Transabdominal Preperitoneal (TAPP) repair of inguinal hernia: A randomized controlled trial. Pak J Med Sci. 2015;31(5):1062-6.
Muschalla F, Schwarz J, Bittner R. Effectivity of laparoscopic inguinal hernia repair (TAPP) in daily clinical practice: early and long-term result. Surgical endoscopy. 2016;30(11):4985-94.
Wright D, Paterson C, Scott N. Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg. 2002;235:333-7.
Nienhuijs S, Staal E, Strobbe L. Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg. 2007;194:394-400
Grant A. Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg. 2000;87(7):860-7.
McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med. 1988:18:1007-19.
Merskey HE. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Pain. 1986.
Tolver MA. Pain characteristics after laparoscopic inguinal hernia repair. Surg Endosc. 2011;25:3859-64.
Koninger J, Redecke J, Butters M. Chronic pain after hernia repair: a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg. 2004;389:361-5.
Bay-Nielsen M, Perkins FM, Kehlet H. Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg. 2001;233:1-7.
Courtney CA, Duffy K, Serpell MG. Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg. 2002;89:1310-4.
Poobalan AS, Bruce J, King PM, et al. Chronic pain and quality of life following open inguinal hernia repair. Br J Surg. 2001;88:1122-6.
Callesen T, Bech K, Kehlet H. Prospective study of chronic pain after groin hernia repair. Br J Surg. 1999;86:1528-31.
Kosai N, Sutton PA, Evans J. Laparoscopic preperitoneal mesh repair using a novel self-adhesive mesh. J Minim Access Surg. 2011;7:192-4.
Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc. 1999;13:804-6.
Tolver MA, Rosenberg J, Juul P. Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc. 2013;27:2727-33.
Brugger L, Bloesch M, Ipaktchi R. Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks. Surg Endosc. 2012:26:1079-85.
Subwongcharoen S, Ruksakul K. A randomized controlled trial of staple fixation versus N-butyl-2cyanoacrylate fixation in laparoscopic inguinal hernia repair. J Med Assoc Thai. 2013;96:8-13.
Pommergaard HC, Burcharth J, Andresen K, Fenger AQ, Rosenberg J. No difference in sexual dysfunction after transabdominal preperitoneal (TAPP) approach for inguinal hernia with fibrin sealant or tacks for mesh fixation. Surgical endoscopy. 2017;31(2):661-6.
Bringman S, Conze J, Cuccurullo D. Hernia repair: the search for ideal meshes. Hernia. 2010;14:81-7.
Weyhe D, Belyaev O, Müller C, Meurer K, Bauer KH, Papapostolou G, et al. Improving outcomes in hernia repair by the use of light meshes- a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg. 2007;31(1):234-44.