Abstract：
BACKGROUND: Chronic pain remains prevalent after open inguinal hernia repair and nerve-handling strategies are debated. Some guidelines suggest sparing nerves that are encountered; however, the nerve identification rates are unclear. This study aimed to investigate the nerve identification rates in a register-based nationwide cohort.
METHODS: This study was reported according to the RECORD guideline and used prospective, routinely collected data from the Danish Hernia Database, which was linked with the National Patient Registry. We included patients ≥ 18 years old, undergoing Lichtenstein hernia repair with information on nerve handling of the iliohypogastric and ilioinguinal nerves.
RESULTS: We included 30,911 open hernia repairs performed between 2012 and 2022. The ilioinguinal nerve was identified in 73% of the repairs and the iliohypogastric nerve in 66% of repairs. Both nerves were spared in more than 94% of cases where they were identified. Female patient sex, emergency and recurrence surgery, general anesthesia, medial and saddle hernias, and large defect size all result in lower nerve identification rates for both nerves.
CONCLUSIONS: The Ilioinguinal nerve was recognized in 73% of cases, while the iliohypogastric nerve was recognized in 66% with almost all identified nerves being spared during surgery. Several pre- and intraoperative factors influenced identification rates of the ilioinguinal and iliohypogastric nerve.
METHODS: This study was reported according to the RECORD guideline and used prospective, routinely collected data from the Danish Hernia Database, which was linked with the National Patient Registry. We included patients ≥ 18 years old, undergoing Lichtenstein hernia repair with information on nerve handling of the iliohypogastric and ilioinguinal nerves.
RESULTS: We included 30,911 open hernia repairs performed between 2012 and 2022. The ilioinguinal nerve was identified in 73% of the repairs and the iliohypogastric nerve in 66% of repairs. Both nerves were spared in more than 94% of cases where they were identified. Female patient sex, emergency and recurrence surgery, general anesthesia, medial and saddle hernias, and large defect size all result in lower nerve identification rates for both nerves.
CONCLUSIONS: The Ilioinguinal nerve was recognized in 73% of cases, while the iliohypogastric nerve was recognized in 66% with almost all identified nerves being spared during surgery. Several pre- and intraoperative factors influenced identification rates of the ilioinguinal and iliohypogastric nerve.
摘要：
背景：开放式腹股沟疝修补术和神经处理策略后，慢性疼痛仍然很普遍。一些指南建议避免遇到的神经；然而，神经识别率尚不清楚。这项研究旨在调查基于注册的全国队列中的神经识别率。
方法：本研究是根据记录指南报告的，常规从丹麦疝数据库收集数据，这与国家患者登记处有关。我们纳入≥18岁的患者，接受Lichtenstein疝修补术，了解髂腹下神经和髂腹股沟神经的神经处理。
结果：我们纳入了2012年至2022年期间进行的30,911例开放性疝修补术。在73％的修复中确定了髂腹股沟神经，在66％的修复中确定了髂腹下神经。在超过94%的病例中，两条神经都得到了保护。女性患者性别，急诊和复发手术，全身麻醉,内侧和鞍状疝,和大的缺损尺寸都会导致两条神经的神经识别率较低。
结论：在73%的病例中发现了髂腹股沟神经，而66％的腹下髂神经被识别，几乎所有确定的神经在手术过程中都得以幸免。几个术前和术中因素影响髂腹股沟和髂腹下神经的识别率。
方法：本研究是根据记录指南报告的，常规从丹麦疝数据库收集数据，这与国家患者登记处有关。我们纳入≥18岁的患者，接受Lichtenstein疝修补术，了解髂腹下神经和髂腹股沟神经的神经处理。
结果：我们纳入了2012年至2022年期间进行的30,911例开放性疝修补术。在73％的修复中确定了髂腹股沟神经，在66％的修复中确定了髂腹下神经。在超过94%的病例中，两条神经都得到了保护。女性患者性别，急诊和复发手术，全身麻醉,内侧和鞍状疝,和大的缺损尺寸都会导致两条神经的神经识别率较低。
结论：在73%的病例中发现了髂腹股沟神经，而66％的腹下髂神经被识别，几乎所有确定的神经在手术过程中都得以幸免。几个术前和术中因素影响髂腹股沟和髂腹下神经的识别率。
