The outcomes of routine ilioinguinal neurectomy in the treatment of chronic pain during herniorrhaphy: A meta-analysis of randomized-controlled trials

Abstract

Summary: The study aimed to evaluate whether an intraoperative ilioinguinal neurectomy (IIN) would reduce the risk of postoperative pain without increasing other complications during tension-free mesh repair compared to those who accepting nerve preservation. We have searched the following databases: PubMed, Cochrane Library, and EMBASE from inception to January 2020 (the cut-off date was 1 January 2020). Two authors independently accomplished the study selection, data extraction, and quality assessment. Of 553 studies reviewed, 7 high-quality randomized-controlled trials (RCTs) were identified. We pooled the related effect values in each included study and conducted a meta-analysis. The pooled results showed that IIN could reduce postoperative pain rate (RR = 0.40, 95% CI: 0.17–0.95) and pain score (SMD = −0.26, 95%CI: −0.46 to −0.06) at 6 months. There are no statistical differences between postoperative numbness rate (RR = 1.48, 95%CI: 0.89–2.47), postoperative sensory disturbance (RD = 0.03, 95% CI: −0.03–0.1) and postoperative secondary complications rate (RR = 0.81, 95%CI: 0.53–1.24) at the same time point. In conclusion, we have found the routine IIN can reduce the incidence of postoperative pain without increasing complications. Therefore, the implementation of this simple intraoperative maneuver may be a major source of postoperative morbidity reduction. Further study on the evaluation of interventions targeted to the IIN is recommended.

Keywords

• Ilioinguinal neurectomy
• Inguinal hernia
• Chronic groin pain
• Meta-analysis