Journal of Clinical and Diagnostic Research (Sep 2022)

Ilioinguinal Nerve Neurectomy vs Nerve Preservation in Lichtenstein Tension Free Mesh Hernioplasty: A Randomised Clinical Trial at a Tertiary Care Hospital in Udaipur, Rajasthan, India

  • Urmil Kumar Labana,
  • Nilesh Mehta,
  • Yashasvi Patel,
  • Mitkumar V Patel,
  • Ajay Chauhan

DOI
https://doi.org/10.7860/JCDR/2022/56991.16871
Journal volume & issue
Vol. 16, no. 9
pp. PC01 – PC05

Abstract

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Introduction: A Lichtenstein tension-free mesh hernioplasty is the most commonly performed surgery for an inguinal hernia. Chronic inguinodynia is the most prevalent surgical complication, with a 25% overall incidence. The second most common complication is hypoesthesia. Ilioinguinal neurectomy has been proven in several studies to alleviate chronic inguinodynia. Aim: To compare the postoperative inguinal pain and aesthesia in Ilioinguinal Nerve (IIN) preservation patients with neurectomy patients in Lichtenstein tension-free mesh hernioplasty. Materials and Methods: This randomised clinical trial was conducted at GMCH, Udaipur, Rajasthan, India during January 2020 to June 2021 on 70 individuals (35 in each group). The IIN was excised in group A, while it was preserved in group B. Pain and aesthesia was assessed at day seven, one month and three month follow-up. Chi-square test was used for data analysis. A p-value <0.05 was considered significant. Results: Mean age of the study sample was 55.95±15.61 years in group A and 55.4±17.22 years in group B. At Postoperative Day-7 (POD-7), 33 (94.28%) patients in group A and 18 (51.43%) patients in group B reported mild pain after vigorous activity, whereas 2 (5.71%) patients in group A and 15 (42.8%) patients in group B reported moderate pain after vigorous activity, and 2 (5.7%) patients in group B reported severe pain after vigorous activity. At POD-7, 2 (5.7%) patients in group A reported hypoaesthesia, out of them only 1 (2.85%) patient reported hypoaesthesia at one month and at three months of follow-up, whereas no patients in group B reported hypoaesthesia at POD-7, one month, or three months of follow-up. Conclusion: It was evident in this study that prophylactic ilioinguinal neurectomy resulted in considerable reduction in incidence of post operative neuralgia, compared to nerve preservation.

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