Les Publications Les résultats du groupe
The aim of our retrospective study was to quantify the incidence of chronic pain and cutaneous sensory changes among various anterior and posterior hernia repairs and then to compare laparoscopic with open tech- niques. A detailed questionnaire was sent in January 1998 to patients operated on from 199z to 1996. Patients had to record their current parietal status and assess the result from their personal point of view. The replies were recorded without any medical adjustment. Of 545 patients treated for 617 groin hernias, 490 were followed for 1 to 5 years (median 3 years, 2 months). One hundred and ten patients (23%) experienced symptoms persisting for more than one year, including 5o cases of cutaneous sensory changes and 71 cases of pain. Twenty-four patients (5%) assessed their discomfort as more troublesome than the hernia they had before, overriding the benefits of a solid repair. There was no statistical difference concerning the incidence of chronic pain between the nonprosthetic and prosthetic ("tension-free") subgroups Or bet- ween the open and laparoscopic subgroups. Forty-five of 5o cutaneous senso- ry changes occurred after the inguinal approach. The incidence of such changes was lo times lower in the laparoscopic than in the open subgroup (p < o.om). Our study confirms that pain and sensory changes are more fre- quent and persistent than generally estimated and that they can interfere with the patient's daiiy life. Posterior approaches, in particular laparoscopic, were associated with statistically fewer sensory changes than inguinal approaches. These results suggest using questionnaires about the quality of life when eva- luating hernia repair.