Efficacy and safety of ilioinguinal neurectomy in open tension-free inguinal hernia repair: A meta-analysis of randomized controlled trials

• Published in: The American journal of surgery Vol. 226; no. 4; pp. 531 - 541
• Main Authors: Hu, Qiang, Du, Ying-Xiu, Wang, Deng-Chao, Yang, Yong-Jun, Lei, Yue-Hua, Wei, Jian
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2023; Elsevier Limited
• Subjects: Chronic pain; Clinical trials; Confidence intervals; Hernia; Hernia repair; Hernias; Ilioinguinal nerve; Meta-analysis; Neurectomy; Pain; Tension; Hernia repair; Neurectomy; Ilioinguinal nerve; Meta-analysis
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2023.06.027

There is still controversy surrounding routine ilioinguinal neurectomy in open tension-free inguinal hernia repair. PubMed, Cochrane Library and EMBASE databases were searched for randomized controlled trials of ilioinguinal neurectomy in open tension-free inguinal hernia repair. Revman 5.3 software was used for meta-analysis. Meta-analysis revealed that the incidence of severe pain on the first postoperative day was lower in the ilioinguinal neurectomy group (ING) than in the ilioinguinal nerve preservation group (INPG) [P < 0.0001]. The incidence of no pain in the first month postoperatively [P = 0.0004], the incidence of no pain in the sixth months postoperatively [P < 0.00001], and the numbness incidence in the first month postoperatively [P = 0.001] in the ING was higher than that in the INPG. There was no significant difference in the incidence of severe pain in the first month postoperatively [P = 0.20], the numbness incidence in the sixth postoperative month [P = 0.05], the hypoesthesia incidence in the first [P = 0.15] and sixth [P = 0.85] postoperative months between the two groups. Ilioinguinal neurectomy in open tension-free inguinal hernia repair can better prevent postoperative pain. •Pain after inguinal hernia repair has become the most common and prominent sequelae.•Neuropathological injury is widely considered to be the cause of chronic pain.•There is still controversy surrounding routine ilioinguinal neurectomy.•Ilioinguinal neurectomy in inguinal hernia repair can prevent postoperative pain.