Predicting chronic post-operative pain following laparoscopic inguinal hernia repair.
BACKGROUND
Chronic post-operative pain (CPP) following laparoscopic inguinal hernia repair (LIHR) may cause significant morbidity and be more problematic than recurrence. Determining pre-operative risk may reduce morbidity. Our aim was to determine prevalence of CPP following LIHR and identify risk factors for its development.


METHODS
Data from patients undergoing LIHR (1996-2004) at one District General Hospital were collected, including demographics, body mass index, pre-operative pain, LIHR type (TEP or TAPP, primary/recurrent, unilateral/bilateral) and post-operative complications including CPP (pain lasting > or = 1 year).


RESULTS
A total of 881 patients underwent LIHR (1,029 hernias). Of these, 523 (60%) patients completed the questionnaire, and 72/523 (13.8%) patients experienced CPP. Presence of pre-operative pain (P < 0.001), recurrent LIHR (P = 0.021) and age < 50 years (P < 0.001) were significantly correlated with CPP.


CONCLUSIONS
Chronic post-operative pain following LIHR is more prevalent than recurrence. Pre-operative pain, surgery for recurrent inguinal hernias (following anterior repair) and younger age at surgery predict development of CPP. Identification of 'high-risk' patients may improve management, reducing morbidity and cost.
Dickinson
K J
KJ
Department of Surgery, Dewsbury and District Hospital, Halifax Road, Dewsbury, WF13 4HS, UK. kdickinson0@hotmail.com
Thomas
M
M
Fawole
A S
AS
Lyndon
P J
PJ
White
C M
CM
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002908:Chronic Disease; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires