Analysis of the Effect and Risk Factors for Postoperative Recurrence and Chronic Pain in Patients with Inguinal Incarcerated Hernia Undergoing Laparoscopic Crochet Hernia Ring Closure Surgery
Objective:To explore the effectiveness of laparoscopic hook needle hernia ring closure in patients with inguinal incarcerated hernia,as well as the risk factors for postoperative recurrence and chronic pain.Methods:A total of 92 patients with inguinal incarcerated hernia admitted to our hospital from January 2018 to December 2021 were selected,they underwent laparoscopic crochet hernia ring closure surgery.The surgical conditions of all patients were analyzed,and postoperative recurrence and chronic pain were used as variables.Logistic regression models were used to analyze the risk factors for postoperative recurrence and pain in inguinal incarcerated hernia patients.Results:The incidence of postoperative complications was 7.61％(7/92),with 4 cases of subcutaneous hematoma,1 case of incision infection,1 case of postoperative bleeding,and 1 case of delayed intestinal perforation.After 2 years of follow-up for all patients,the incidence of postoperative chronic pain was 16.30％(15/92),including 5 cases of mild pain,7 cases of moderate pain,and 3 cases of severe pain.The postoperative recurrence rate was 10.87％(10/92);There was no difference in gender,age,comorbidities,hernia anatomical classification,lesion location,postoperative drainage,patch type,and emergency surgery between the chronic pain group and the non chronic pain group(P＞0.05).However,there was a significant difference in BMI,number of surgeries,intraoperative neuroprotection,and preoperative pain in the operating area between the chronic pain group and the non chronic pain group(P＜0.05).There was no difference between the recurrent group and the non recurrent group in terms of age,coronary heart disease,number of operations,intraoperative nerve protection,lesion location,postoperative drainage,patch type,preoperative pain in the operating area(P＞0.05).There were significant differences between the recurrent group and the non recurrent group in terms of gender,BMI,diabetes,hypertension,hernia anatomy classification,and emergency surgery(P＜0.05);BMI,diabetes,hypertension and hernia anatomy were classified as independent risk factors for recurrence after inguinal pin hernioplasty for incarcerated hernia(P＜0.05);BMI,number of surgeries,and preoperative pain in the operating area are independent risk factors for postoperative chronic pain in inguinal incarcerated hernia treated with inguinal needle closure,while intraoperative neuroprotection is a protective factor(P＜0.05).Conclusion:Laparoscopic hook needle herniorrhaphy for inguinal incarcerated hernia is effective and safe.However,some patients still have postoperative recurrence and chronic pain.BMI,diabetes,hypertension and hernia anatomy are risk factors for postoperative recurrence.BMI,number of surgeries,and preoperative pain in the surgical area are risk factors for postoperative chronic pain,while intraoperative neuroprotection is a protective factor.
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