Romain B, Fabacher T, Ortega-Deballon P, Montana L, Cossa J-P, Gillion J-F
Service de Chirurgie Générale Et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67098, Strasbourg Cedex, France.
Department of Digestive Surgery, Strasbourg University, 1 Avenue Moliere, 67000, Strasbourg, France.
Hernia. 2022 Feb;26(1):189-200. doi: 10.1007/s10029-021-02404-w. Epub 2021 Apr 23.
To assess the rate of late chronic postoperative inguinal pain (CPIP) after groin hernia repair in patients with different categories of preoperative VRS (Verbal Rating Scale) pain and to make a pragmatic evaluation of the rates of potentially surgery-related CPIP vs. postoperative continuation of preexisting preoperative pain.
Groin pain of patients operated from 01/11/2011 to 01/04/2014 was assessed preoperatively, postoperatively and at 2-year follow-up using a VRS-4 in 5670 consecutive groin hernia repairs. A PROM (Patient Related Outcomes Measurement) questionnaire studied the impact of CPIP on the patients' daily life.
Relevant (moderate or severe VRS) pain was registered preoperatively in 1639 of 5670 (29%) cases vs. 197 of 4704 (4.2%) cases at the 2-year follow-up. Among the latter, 125 (3.7%) cases were found in 3353 cases with no-relevant preoperative pain and 72 (5.3%) in 1351 cases with relevant preoperative pain. Relevant CPIP consisted of 179 (3.8%) cases of moderate pain and 18 (0.4%) cases of severe pain. The rate of severe CPIP was independent of the preoperative VRS-pain category while the rate of moderate CPIP (3.1%, 3.4%, 4.1%, 6.8%) increased in line with the preoperative (none, mild, moderate, and severe) VRS-pain categories. The VRS probably overestimated pain since 71.6% of the relevant CPIP patients assessed their pain as less bothersome than the hernia.
At the 2-year follow-up, relevant CPIP was registered in 4.2% cases, of which 63.5% were potentially surgery-related (no-relevant preoperative pain) and 36.5% possibly due to the postoperative persistence of preoperative pain. The rate of severe CPIP was constant around 0.4%.
评估不同术前VRS（视觉模拟评分法）疼痛分类的患者腹股沟疝修补术后迟发性慢性腹股沟疼痛（CPIP）的发生率，并对潜在的手术相关CPIP发生率与术前原有疼痛术后持续存在的发生率进行务实评估。
对2011年11月1日至2014年4月1日接受手术的患者，在5670例连续腹股沟疝修补术中，术前、术后及2年随访时使用VRS-4评估腹股沟疼痛情况。一份患者相关结局测量（PROM）问卷研究了CPIP对患者日常生活的影响。
5670例患者中有1639例（29%）术前记录有相关（中度或重度VRS）疼痛，而在2年随访时4704例中有197例（4.2%）。在后者中，3353例术前无相关疼痛的患者中有125例（3.7%），1351例术前有相关疼痛的患者中有72例（5.3%）。相关CPIP包括179例（3.8%）中度疼痛和18例（0.4%）重度疼痛。重度CPIP的发生率与术前VRS疼痛分类无关，而中度CPIP的发生率（3.1%、3.4%、4.1%、6.8%）随术前（无、轻度、中度和重度）VRS疼痛分类增加。VRS可能高估了疼痛，因为71.6%的相关CPIP患者认为他们的疼痛比疝气带来的困扰小。
在2年随访时，4.2%的病例记录有相关CPIP，其中63.5%可能与手术相关（术前无相关疼痛），36.5%可能是由于术前疼痛术后持续存在。重度CPIP的发生率恒定在0.4%左右。
