Influence of preservation versus division of ilioinguinal, iliohypogastric, and genital nerves during open mesh herniorrhaphy: prospective multicentric study of XXXX .

@entity1 @entity158 @entity547 @entity169 @entity282 @entity1118 @entity9
OBJECTIVE: To evaluate whether the various surgical treatment reserved for @entity9 , during open @entity547 mesh repair, is effective in reducing chronic @entity282 . BACKGROUND: Interest in chronic @entity158 following herniorrhaphy has escalated, in recent years, due both to treatment and legal implications. However, much debate still exists concerning which treatment to reserve for the 3 inguinal sensory nerves. METHODS: A multicentric prospective study involving 11 Italian institutions led to the recruitment of 973 cases of hernioplasty. All surgeons were asked to report whether or not each nerve had been identified and preserved or divided. The main endpoint of the study was the evaluation of moderate to severe @entity1118 at 6 months and 1 year. RESULTS: Overall, the presence of @entity158 at the 6-month and 1-year follow-up was 9.7% and 4.1%, respectively. @entity158 was mild in 7.9% and moderate to severe in 2.1%, at 6 months, and mild in 3.6% and moderate to severe in 0.5%, at 1 year. Univariate and multivariate analysis showed that lack of identification of nerves is significantly correlated with presence of @entity1118 , the risk of developing @entity158 increasing with the number of nerves not detected. Likewise, division of nerves was clearly correlated with presence of @entity1118 . CONCLUSIONS: The present findings indicate that identification and preservation of nerves during open @entity169 reduce chronic incapacitating @entity158 and that, in the majority of @entity1 with @entity1118 at 6 months, the @entity158 at 1 year is resolved only with conservative or medical treatment.
