Chronic groin pain following inguinal hernia repair in the laparoscopic era: Systematic review and meta-analysis

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Authors
Sekhon Inderjit Singh, H. K.
Massey, L. H.
Arulampalam, T.
Motson, R. W.
Pawa, N.
Journal
American journal of surgery
Type
Journal Article
Publisher
Elsevier
Rights
Copyright © 2022 Elsevier Inc. All rights reserved.
BACKGROUND: The impact of laparoscopic inguinal hernia repair (IHR) on chronic groin pain (CGP) prevalence, risk and daily activities compared to open IHR is still unclear. METHODS: A meta-analysis of randomised controlled trials comparing CGP rates in laparoscopic and open IHR was performed. RESULTS: 22 trials were included. CGP prevalence decreases significantly 1-2 years post-op and reaches rates as low as 4.69% (laparoscopic) and 6.91% (open) at >5 years. There is a significantly lower risk of CGP following totally extraperitoneal (TEP) than open mesh repair at all follow-up periods (p < 0.05) except for >5 years (p = 0.32). The same trend is not seen when compared to open non-mesh repair or for transabdominal pre-peritoneal repair (TAPP). There is no difference between techniques when CGP is described as moderate and/or affecting daily activities (p = 0.08). CONCLUSION: CGP rates continue to decrease at >5 years follow up. TEP consistently results in a reduction in CGP rates compared to open mesh repair however, this is not functionally significant.
Citation
Am J Surg. 2022 May 21:S0002-9610(22)00305-1. doi: 10.1016/j.amjsurg.2022.05.005.
Note
Supports Open Access