Causes, prevention, and surgical treatment of postherniorrhaphy neuropathic inguinodynia: Triple neurectomy with proximal end implantation

被引：155

作者：

Amid P.K. ^{[1
,2
,3
]}

机构：

[1] Lichtenstein Hernia Institute, Los Angeles, CA 90036

[2] Department of Surgery, Harbor-UCLA Medical Center, Los Angeles, CA

[3] Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA

来源：

Hernia | 2004年 / 8卷 / 4期

关键词：

Meshoma; Postherniorrhaphy chronic pain; Postherniorrhaphy neuropathic pain; Tripleneurectomy for postherniorrhaphy chronic pain;

D O I：

10.1007/s10029-004-0247-0

中图分类号：

学科分类号：

摘要：

The recommended surgical treatment for chronic neuropathic pain after herniorrhaphy has been a two-stage operation including: (a) ilioinguinal and iliohypogastric neurectomies through an inguinal approach and (b) genital nerve neurectomy through a flank approach. Two hundred twenty-five patients underwent triple neurectomies with proximal end implantation to treat chronic postherniorrhaphy neuralgia. Four patients reported no improvement. Eighty percent of patients recovered completely, and 15% had transient insignificant pain with no functional impairment. These results are comparable to the results of the two-stage operation. Simultaneous neurectomy of the ilioinguinal, iliohypogastric, and genital nerves without mobilization of the spermatic cord is an effective one-stage procedure to treat postherniorrhaphy neuralgia. It can be performed under local anesthesia and avoids testicular complications. Proximal end implantation of the nerves prevents adherence of the cut ends to the aponeurotic structures of the groin, which can result in recurrence of the pain. A one-stage surgical procedure resecting all three nerves from an anterior approach avoids a second operation through the flank and successfully treats chronic neuralgia. © Springer-Verlag 2004.

引用

页码：343 / 349

页数：6

共 12 条

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