Bi Andrew, Park Eugene, Dumanian Gregory A
Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2018 Mar 6;6(3):e1670. doi: 10.1097/GOX.0000000000001670. eCollection 2018 Mar.
Neuromas can be a debilitating cause of pain and often negatively affect patients' quality of life. One effective method of treatment involves surgical resection of the painful neuroma and use of a processed nerve allograft to repair the injured nerve segment. Giving the nerve "somewhere to go and something to do" has been shown to effectively alleviate pain in upper and lower extremities. We present the first report of this concept to treat a painful neuroma of the abdominal wall that developed following a laparoscopic gastric bypass. The neuroma was excised, and the affected nerve was reconstructed using a processed nerve allograft as an interposition graft, with resolution of pain and gradual return of normal sensation. Patient-reported outcomes were measured using the Patient Reported Outcomes Measurement Information System. Neuroma excision with concurrent interposition grafting using processed nerve allografts may be a promising method of treatment for postsurgical painful neuromas of the trunk.
神经瘤可能是导致疼痛的一个使人衰弱的原因,并且常常对患者的生活质量产生负面影响。一种有效的治疗方法包括手术切除疼痛性神经瘤,并使用经过处理的同种异体神经移植来修复受损的神经节段。让神经“有地方可去且有事可做”已被证明能有效缓解上肢和下肢的疼痛。我们首次报告了这一概念用于治疗腹腔镜胃旁路术后发生的腹壁疼痛性神经瘤。切除神经瘤,并使用经过处理的同种异体神经移植作为间置移植来重建受影响的神经,疼痛得以缓解,正常感觉逐渐恢复。使用患者报告结局测量信息系统来测量患者报告的结局。神经瘤切除并同时使用经过处理的同种异体神经进行间置移植可能是治疗躯干术后疼痛性神经瘤的一种有前景的方法。