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Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses

PURPOSE: Inguinal hernia repair is one of the most common operations worldwide and despite this, the incidence of chronic pain remains high after inguinal hernia repair. The optimal nerve handling strategy is controversial and the rate at which nerves are identified remains uncertain. This study aim...

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Autores principales: Moseholm, Viktor Bay, Baker, Jason Joe, Rosenberg, Jacob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598160/
https://www.ncbi.nlm.nih.gov/pubmed/37874414
http://dx.doi.org/10.1007/s00423-023-03154-2
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author Moseholm, Viktor Bay
Baker, Jason Joe
Rosenberg, Jacob
author_facet Moseholm, Viktor Bay
Baker, Jason Joe
Rosenberg, Jacob
author_sort Moseholm, Viktor Bay
collection PubMed
description PURPOSE: Inguinal hernia repair is one of the most common operations worldwide and despite this, the incidence of chronic pain remains high after inguinal hernia repair. The optimal nerve handling strategy is controversial and the rate at which nerves are identified remains uncertain. This study aimed to determine the identification rates of the ilioinguinal, iliohypogastric, and genitofemoral nerves as well as nerve handling strategies. METHODS: This review was registered on PROSPERO (CRD 42023416576). PubMed, Embase, and Cochrane Central were systematically searched. Studies with more than 10 patients were included if they reported an identification rate for at least one of the nerves during elective open inguinal hernia repair in adults. Studies requiring nerve identification in their study design were excluded. Bias was assessed with the JBI critical appraisal tool and Cochrane’s RoB-2 tool. The overall estimate of the prevalence was analysed with prevalence meta-analyses. RESULTS: A total of 22 studies were included. The meta-analyses included 18 studies, which resulted in an identification rate of 82% (95% CI: 76–87%) for the ilioinguinal nerve, 62% (95% CI: 54–71%) for the iliohypogastric nerve, and 41% (95% CI: 27–55%) for the genitofemoral nerve. Nerves were spared in 82% of all repairs. CONCLUSION: The ilioinguinal, iliohypogastric, and genitofemoral nerves were identified in 82%, 62%, and 41% of surgeries, respectively. Most studies used a nerve-preserving strategy. The role of nerve identification in the development of chronic pain remains uncertain, as well as the optimal nerve handling strategy.
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spelling pubmed-105981602023-10-26 Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses Moseholm, Viktor Bay Baker, Jason Joe Rosenberg, Jacob Langenbecks Arch Surg Systematic Review PURPOSE: Inguinal hernia repair is one of the most common operations worldwide and despite this, the incidence of chronic pain remains high after inguinal hernia repair. The optimal nerve handling strategy is controversial and the rate at which nerves are identified remains uncertain. This study aimed to determine the identification rates of the ilioinguinal, iliohypogastric, and genitofemoral nerves as well as nerve handling strategies. METHODS: This review was registered on PROSPERO (CRD 42023416576). PubMed, Embase, and Cochrane Central were systematically searched. Studies with more than 10 patients were included if they reported an identification rate for at least one of the nerves during elective open inguinal hernia repair in adults. Studies requiring nerve identification in their study design were excluded. Bias was assessed with the JBI critical appraisal tool and Cochrane’s RoB-2 tool. The overall estimate of the prevalence was analysed with prevalence meta-analyses. RESULTS: A total of 22 studies were included. The meta-analyses included 18 studies, which resulted in an identification rate of 82% (95% CI: 76–87%) for the ilioinguinal nerve, 62% (95% CI: 54–71%) for the iliohypogastric nerve, and 41% (95% CI: 27–55%) for the genitofemoral nerve. Nerves were spared in 82% of all repairs. CONCLUSION: The ilioinguinal, iliohypogastric, and genitofemoral nerves were identified in 82%, 62%, and 41% of surgeries, respectively. Most studies used a nerve-preserving strategy. The role of nerve identification in the development of chronic pain remains uncertain, as well as the optimal nerve handling strategy. Springer Berlin Heidelberg 2023-10-24 2023 /pmc/articles/PMC10598160/ /pubmed/37874414 http://dx.doi.org/10.1007/s00423-023-03154-2 Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Systematic Review
Moseholm, Viktor Bay
Baker, Jason Joe
Rosenberg, Jacob
Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title_full Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title_fullStr Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title_full_unstemmed Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title_short Nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
title_sort nerve identification during open inguinal hernia repair: a systematic review and meta-analyses
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10598160/
https://www.ncbi.nlm.nih.gov/pubmed/37874414
http://dx.doi.org/10.1007/s00423-023-03154-2
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