腹股沟疝无张力疝修补术补片及术后慢性疼痛的认识

Mesh and postoperative chronic pain of tension-free hernioplasty

无张力疝修补术在临床上广泛应用后,腹股沟疝术后复发率已被大大减少,然而我们的关注点从复发转移到了术后慢性疼痛,虽然一般疼痛可以被镇痛药控制,但是患者生活质量因此受到了显著的影响,所以术后慢性疼痛变成一个重要的问题。疝修补术后慢性疼痛的原因至今尚不明。在市场上有很多可供选择的补片,但很难从中选择一个术后疼痛最小的补片。对慢性疼痛的适宜治疗措施的选择也是有争议的,且相关研究对慢性疼痛的定义缺乏共识,这使得对不同的研究结果进行meta分析及系统评价变得更加复杂。

Hernia recurrence rate of inguinal hernia repair has been greatly reduced with the widely spread of tension-free hernia repair. However, our attention has shifted from recurrence to postoperative chronic pain. Although general pain can be controlled by analgesics, the quality of life of patients have been significantly affected. Therefore, the chronic pain has become an important issue. The Cause of chronic pain following tension-free hernia repair is still unclear. There are numerous of meshes available in the market, but it is difficult to choose one of the best. The choice of appropriate treatment options for chronic pain is also controversial, and the lack of consensus on the definition of chronic pain makes different results of metaanalysis and systematic review more complicated.