Budney Sarah, Kleppe Kyle, Mancini Matthew, Mancini Greg, Phillips Melissa, McKnight Catherine, Griepentrog John, Reinhorn Michael, Fafaj Aldo, Blake Kaela E
University of Tennessee Graduate School of Medicine, Knoxville, TN, 37920, USA.
Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, 37920, USA.
Hernia. 2025 Sep 17;29(1):275. doi: 10.1007/s10029-025-03469-7.
Mesh properties are important contributing factors to chronic postoperative inguinal pain (CPIP) following Lichtenstein inguinal hernia repair. Some studies show using a light-weight mesh (LWM, <50 g/m2) over heavy-weight mesh (HWM, >70 g/m2) may decrease CPIP. However, most studies do not distinguish between partially absorbable light-weight mesh (PA-LWM) and permanent LWM. This study compares the rates of CPIP between PA-LWM, LWM, and HWM after Lichtenstein inguinal hernia repair.
A retrospective analysis of the ACHQC database from 2014 to 2024 was conducted for elective Lichtenstein repair of non-recurrent, unilateral inguinal hernias. Mesh was categorized as LWM <50 g/m2 or HWM ≥70 g/m2 distinguishing partially absorbable LWM. The primary outcome was the rate of CPIP at 6 months postoperatively for PA-LWM, LWM, and HWM.
319 patients met criteria for the study with 53 PA-LWM, 122 LWM, and 144 HWM patients. Baseline pain was highest in PA-LWM and lowest in HWM cohorts. At 6 months, 21% of PA-LWM, 21% of LWM, and 19% of HWM patients had chronic pain (p=0.93). This decreased to 3% for PA-LWM at 1-year, but remained approximately 20% for LWM and HWM (p = 0.045). The clinical recurrence rate at 1-year was 50% (2/4), 0% (0/8), and 0% (0/17) for PA-LWM, LWM, and HWM respectively (p = 0.001).
This study found that roughly 20% of patients have chronic pain at 6 months regardless of mesh weight or partially absorbable properties. While PA-LWM may decrease CPIP at 1 year, this may be accompanied with a higher clinical recurrence rate.
补片特性是Lichtenstein腹股沟疝修补术后慢性腹股沟疼痛（CPIP）的重要影响因素。一些研究表明，使用轻质补片（LWM，<50 g/m2）而非重质补片（HWM，>70 g/m2）可能会降低CPIP。然而，大多数研究并未区分部分可吸收轻质补片（PA-LWM）和永久性LWM。本研究比较了Lichtenstein腹股沟疝修补术后PA-LWM、LWM和HWM之间的CPIP发生率。
对2014年至2024年ACHQC数据库进行回顾性分析，纳入非复发性单侧腹股沟疝择期Lichtenstein修补术患者。补片分为LWM<50 g/m2或HWM≥70 g/m2，区分部分可吸收LWM。主要结局是PA-LWM、LWM和HWM术后6个月的CPIP发生率。
319例患者符合研究标准，其中53例使用PA-LWM，122例使用LWM，144例使用HWM。PA-LWM组基线疼痛最高，HWM组最低。6个月时，21%的PA-LWM患者、21%的LWM患者和19%的HWM患者有慢性疼痛（p=0.93）。1年时PA-LWM组降至3%，但LWM组和HWM组仍约为20%（p=0.045）。PA-LWM组、LWM组和HWM组1年时的临床复发率分别为50%（2/4）、0%（0/8）和0%（0/17）（p=0.001）。
本研究发现，无论补片重量或部分可吸收特性如何，约20%的患者在术后6个月有慢性疼痛。虽然PA-LWM可能在1年时降低CPIP，但可能伴随着更高的临床复发率。
