Planned ilioinguinal nerve excision for prevention of chronic pain after inguinal hernia repair: A meta-analysis

Surgery, 06/08/2011

Johner A et al. – A planned resection of the ilioinguinal nerve at the time of inguinal hernia repair is associated with a decrease in the incidence of chronic postoperative pain. Thus, carrying out this simple maneuver at the time of operation might decrease a major source of postoperative patient morbidity.

Methods

  • A systematic literature review was carried out to identify studies investigating the influence of ilioinguinal nerve excision on the development of chronic pain after inguinal hernia repair.
  • A quantitative analysis of the pooled data was carried out.

Results

  • Of 6,023 abstracts reviewed, 4 high-quality, randomized-controlled trials were identified.
  • The pooled mean difference in degree of pain at 6 months postoperatively on a 10-point scale was -0.29 (95% confidence interval: -0.48 to -0.11), favoring neurectomy to decrease the chance of developing chronic pain.
  • Not surprisingly, those individuals undergoing neurectomy were also more likely to develop altered sensation at the same time point (odds ratio: 3.70, 95% confidence interval: 2.61-5.25).

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