Chronic pain after two laparoendoscopic inguinal hernia repairs compared with laparoendoscopic repair followed by the Lichtenstein repair: an international questionnaire study
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Chronic pain after two laparoendoscopic inguinal hernia repairs compared with laparoendoscopic repair followed by the Lichtenstein repair : an international questionnaire study. / Öberg, Stina; Andresen, Kristoffer; Nilsson, Hanna; Angenete, Eva; Rosenberg, Jacob.
I: Surgical Endoscopy, Bind 34, Nr. 2, 02.2020, s. 946-953.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Chronic pain after two laparoendoscopic inguinal hernia repairs compared with laparoendoscopic repair followed by the Lichtenstein repair
T2 - an international questionnaire study
AU - Öberg, Stina
AU - Andresen, Kristoffer
AU - Nilsson, Hanna
AU - Angenete, Eva
AU - Rosenberg, Jacob
PY - 2020/2
Y1 - 2020/2
N2 - BACKGROUND: The best repair of a recurrent inguinal hernia after primary laparoendoscopic repair is debatable. The aim was to assess chronic pain after two laparoendoscopic repairs in the same groin compared with Lichtenstein reoperation preceded by a laparoendoscopic repair.METHODS: This cohort study included adult patients who had received two laparoendoscopic repairs (Lap-Lap) or a laparoendoscopic repair followed by the Lichtenstein repair (Lap-Lich). Eligible patients were identified in the Danish and the Swedish hernia databases. Lap-Lap was matched 1:3 with Lap-Lich, and patients were sent validated questionnaires. The primary outcome was the proportion with chronic pain-related functional impairment, compared between the two groups. Secondary outcomes included chronic pain during various activities.RESULTS: In total, 74% (546 patients) responded to the questionnaires with a median follow-up since the second repair of 4.9 years (0.9-21.9 years). Regarding the primary outcome, 21% in Lap-Lap and Lap-Lich had chronic pain-related functional impairment of daily activities (p = 0.94). More patients in Lap-Lap compared with Lap-Lich reported pain ≥ 20 mm measured by the visual analog scale, 11% versus 5%, p = 0.04. However, there was no difference in the median VAS score or in the vast majority of the remaining secondary outcomes.CONCLUSIONS: There was no overall difference in chronic pain between patients who had received Lap-Lap compared with Lap-Lich. Choice of operative strategy for the second repair should, therefore, not be based on risk of chronic pain.
AB - BACKGROUND: The best repair of a recurrent inguinal hernia after primary laparoendoscopic repair is debatable. The aim was to assess chronic pain after two laparoendoscopic repairs in the same groin compared with Lichtenstein reoperation preceded by a laparoendoscopic repair.METHODS: This cohort study included adult patients who had received two laparoendoscopic repairs (Lap-Lap) or a laparoendoscopic repair followed by the Lichtenstein repair (Lap-Lich). Eligible patients were identified in the Danish and the Swedish hernia databases. Lap-Lap was matched 1:3 with Lap-Lich, and patients were sent validated questionnaires. The primary outcome was the proportion with chronic pain-related functional impairment, compared between the two groups. Secondary outcomes included chronic pain during various activities.RESULTS: In total, 74% (546 patients) responded to the questionnaires with a median follow-up since the second repair of 4.9 years (0.9-21.9 years). Regarding the primary outcome, 21% in Lap-Lap and Lap-Lich had chronic pain-related functional impairment of daily activities (p = 0.94). More patients in Lap-Lap compared with Lap-Lich reported pain ≥ 20 mm measured by the visual analog scale, 11% versus 5%, p = 0.04. However, there was no difference in the median VAS score or in the vast majority of the remaining secondary outcomes.CONCLUSIONS: There was no overall difference in chronic pain between patients who had received Lap-Lap compared with Lap-Lich. Choice of operative strategy for the second repair should, therefore, not be based on risk of chronic pain.
U2 - 10.1007/s00464-019-06853-4
DO - 10.1007/s00464-019-06853-4
M3 - Journal article
C2 - 31144120
VL - 34
SP - 946
EP - 953
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
IS - 2
ER -
ID: 236326978