内镜下腹膜后神经切除术治疗腹股沟手术后慢性疼痛
Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery.
作者信息
Giger U, Wente M N, Büchler M W, Krähenbühl S, Lerut J, Krähenbühl L
机构信息
Department of Visceral Surgery, Lindenhof Hospital Berne, Berne, Switzerland.
出版信息
Br J Surg. 2009 Sep;96(9):1076-81. doi: 10.1002/bjs.6623.
BACKGROUND
Chronic postoperative pain after inguinal surgery remains a difficult problem. The role of minimally invasive surgery in this complex setting is still unexplored.
METHODS
Between January 1997 and January 2007, 34 men and five women with a mean(s.d.) age of 47(16) years underwent endoscopic retroperitoneal neurectomy (ERN) for chronic neuropathic groin pain due to genitofemoral nerve with or without ilioinguinal nerve entrapment. Follow-up data were obtained 1 and 12 months after surgery.
RESULTS
At both timepoints after ERN, the severity of chronic postoperative groin pain at rest and during daily activities, and the rate of occupational disability, were significantly decreased in 27 of the 39 patients compared with preoperative values (all P < 0.001).
CONCLUSION
ERN for chronic postoperative genitofemoral nerve entrapment neuropathy was successful in the majority of patients selected for the procedure. This minimally invasive approach allows simultaneous neurectomy of genitofemoral and ilioinguinal nerves.
背景
腹股沟手术后的慢性疼痛仍是一个难题。微创手术在这种复杂情况下的作用仍未得到探索。
方法
在1997年1月至2007年1月期间，34名男性和5名女性，平均（标准差）年龄为47（16）岁，因生殖股神经伴或不伴有髂腹股沟神经卡压导致慢性神经性腹股沟疼痛，接受了内镜下腹膜后神经切除术（ERN）。在术后1个月和12个月获得随访数据。
结果
ERN术后两个时间点，39例患者中的27例静息和日常活动时慢性术后腹股沟疼痛的严重程度以及职业残疾率与术前值相比均显著降低（所有P<0.001）。
结论
对于大多数因慢性术后生殖股神经卡压性神经病变而选择该手术的患者，ERN手术是成功的。这种微创方法允许同时切除生殖股神经和髂腹股沟神经。
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