Influence of surgical methods and patch material on chronic pain after inguinal hernia surgery

Abstract

Objective To analyze the effects of operative method and patch material on chronic pain after inguinal hernia surgery. Methods A total of 536 patients who underwent open tension-free herniorrhaphy in the Hospital of Nan’an City from January 2013 to January 2016 were collected. The operation methods included modified Kugel operation, Lichtenstein operation, Milikan operation and UHS operation. Patients were followed up after surgery and the patients who had chronic pain were analyzed to investigate the influence of surgical methods and patch materials on chronic pain. Results Among the 536 patients, 157 cases underwent modified Kugel operation, 122 cases were treated by Lichtenstein operation, 158 cases were treated by Milikan operation and 99 cases were treated by UHS operation. There were 111 cases of postoperative chronic pain after operation, the incidence of chronic pain was 24.4%, of which 33.8%(53/157) presented in modified Kugel operation, 14.8%(18/122) was caused by Lichtenstein operation, 5.8%(25/158) presented in Milikan operation and 15.2%(15/99) occurred in UHS operation, the incidence of chronic pain in modified Kugel was higher than that in Lichtenstein, Milikan and UHS operation (P 0.05). A total of 379 cases (Lichtenstein, Milikan, UHS operation) were treated with lightweight patch, the incidence of chronic pain after lightweight patch operation was 15.3%(58/379); a total of 157 cases were treated with weight-type patch (modified Kugel operation), the incidence of chronic pain after operation was 33.8%(53/157); the difference in incidence of chronic pain was statistically significant between the two kinds of patch (P<0.05). Conclusions Chronic pain is a common complication after open inguinal hernia operation. Modified Kugel surgery has a higher incidence of chronic pain than Lichtenstein, Milikan and UHS operation. Lightweight patch has less incidence of chronic pain than weight-type patch, and material of the patch may be the factor to the higher incidence of chronic pain after the Modified Kugel. Key words: Chronic pain; Inguinal hernia; Tension-free herniorrhaphy