Dolor Crónico tras Hernioplastía Primaria vs Con Malla

Randomized clinical trial of mesh versus non-mesh primary inguinal hernia repair: Long-term chronic pain at 10 years
Ruben van Veen, Arthur Wijsmuller, Wietske Vrijland, Wim Hop, Johan Lange and Johannus Jeekel. University Medical Center, Rotterdam, The Netherlands
Surgery 2007;142(5):695-8.

Background
Open mesh or non-mesh inguinal hernia repair may influence the incidence of chronic postoperative pain differently.

Methods
A total of 300 patients scheduled for repair of a primary unilateral inguinal hernia were randomized to non-mesh or mesh repair. The primary outcome measure was clinical outcome including persistent pain and discomfort interfering with daily activity. Long-term results at 3 years of follow-up have been published. Included here are 10-year follow-up results with respect to pain.

Results
Of the 300 patients, 87 patients (30%) died and 49 patients (17%) were lost to follow-up. A total of 153 were physically examined in the outpatient clinic after a median long-term follow-up of 129 months (range, 109 to 148 months). None of the patients in the non-mesh or mesh group suffered from persistent pain and discomfort interfering with daily activity.

Conclusions
Our 10-year follow-up study provides evidence that mesh repair of inguinal hernia is equal to non-mesh repair with respect to long-term persistent pain and discomfort interfering with daily activity. An important new finding from the patient’s perspective is that chronic postoperative pain seems to dissipate over time.