Palumbo P, Minicucci A, Nasti A G, Simonelli I, Vietri F, Angelici A M
Dipartimento di Chirurgia Francesco Durante, 1st Faculty of Medicine, Università degli Studi di Roma La Sapienza, Azienda Policlinico Umberto I, Viale del Policlinico 155, Rome 00161, Italy.
Hernia. 2007 Dec;11(6):527-31. doi: 10.1007/s10029-007-0268-6. Epub 2007 Aug 1.
Following an inguinal hernia repair with open or laparoscopic technique, 1-15% of patients show persistent neuralgia, a severe, potentially debilitating, complication. Several therapeutic procedures have been proposed, but consensus regarding choice of treatment has not yet been achieved. We performed a prospective study on 32 such cases. Patients underwent anaesthetic infiltration to identify, when possible, the involved nerve, and we then carried out a step-by-step therapeutic protocol. In the initial phase, patients were treated with oral analgesic and afterwards with repeated infiltrations of anaesthetic and cortisone. Surgery was reserved for patients not responding to the infiltrations, though with no good success. The authors believe that noninvasive methods are to be preferred, whereas neurectomy interventions should be reserved for selected cases.
采用开放或腹腔镜技术进行腹股沟疝修补术后，1%至15%的患者会出现持续性神经痛，这是一种严重的、可能导致身体衰弱的并发症。已经提出了几种治疗方法，但在治疗选择上尚未达成共识。我们对32例此类病例进行了前瞻性研究。患者接受麻醉浸润以尽可能确定受累神经，然后我们实施了逐步治疗方案。在初始阶段，患者先接受口服镇痛药治疗，随后接受麻醉剂和皮质激素的反复浸润治疗。对于对浸润治疗无反应的患者则进行手术，但效果不佳。作者认为应首选非侵入性方法，而神经切除术应仅用于特定病例。
