Does Re-surgery Improve Somatosensory Outcomes in Persistent Pain After Groin Hernia Repair
NCT ID: NCT05238571
Last Updated: 2022-11-28
Study Results
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Basic Information
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COMPLETED
60 participants
OBSERVATIONAL
2009-04-24
2015-03-19
Brief Summary
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Detailed Description
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Quantitative somatosensory testing (QST) is an investigational psychophysiological tool with the potential to uncover the putative pathophysiological substrate in PSPG, i.e., neuropathic and inflammatory constituents. The method may also be used to quantitate changes induced by the re-surgery. Since re-surgery is a neuroablative procedure, essentially performed in previously damaged tissue, it is of interest to examine the extent of neurological perturbations, i.e., 'loss' and 'gain' of sensory functions and the relation to clinical outcome measures.
The authors are only aware of one previous PSPG-study (n = 21) finding that re-surgery, including meshectomy and selective neurectomy, was associated with increased pain pressure thresholds, decreased pain ratings and improved pain-related functional measures. The objectives of the current study, comparing pre with post-re-surgery data, were first to perform a more detailed analysis of the quantitative somatosensory data regarding 'loss' and 'gain' of sensory functions and their relation to clinical outcome measures. Second, to corroborate the clinical outcome findings of the previous study using a threefold larger cohort.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Interventions
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Re-surgery
Re-surgery with meshectomy and selective neurectomy
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
18 Years
ALL
No
Sponsors
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mads u werner
OTHER
Responsible Party
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mads u werner
Principal Investigator, MD, DMSci
Locations
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Multidisciplinary Pain Center, Neuroscience Center, Copenhagen University Hospital, DENMARK
Copenhagen, , Denmark
Countries
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References
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Bande D, Molto L, Pereira JA, Montes A. Chronic pain after groin hernia repair: pain characteristics and impact on quality of life. BMC Surg. 2020 Jul 6;20(1):147. doi: 10.1186/s12893-020-00805-9.
Chapman CR, Vierck CJ. The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. J Pain. 2017 Apr;18(4):359.e1-359.e38. doi: 10.1016/j.jpain.2016.11.004. Epub 2016 Nov 28.
Campanelli G, Bruni PG, Morlacchi A, Cavalli M. Chronic Pain after Inguinal Hernia Repair. In: Campanelli G, editor. Inguinal Hernia Surgery. Milano: Springer Milan; 2017. p. 157-68.
Nikkolo C, Kirsimagi U, Vaasna T, Murruste M, Suumann J, Seepter H, Lepner U. Prospective study evaluating the impact of severity of chronic pain on quality of life after inguinal hernioplasty. Hernia. 2017 Apr;21(2):199-205. doi: 10.1007/s10029-016-1569-4. Epub 2016 Dec 26.
HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12.
Jorgensen SG, Oberg S, Rosenberg J. Treatment of longstanding groin pain: a systematic review. Hernia. 2019 Dec;23(6):1035-1044. doi: 10.1007/s10029-019-01919-7. Epub 2019 Feb 28.
Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res. 2018 Apr 5;11:675-681. doi: 10.2147/JPR.S127820. eCollection 2018.
Jensen EK, Ringsted TK, Bischoff JM, Petersen MA, Rosenberg J, Kehlet H, Werner MU. A national center for persistent severe pain after groin hernia repair: Five-year prospective data. Medicine (Baltimore). 2019 Aug;98(33):e16600. doi: 10.1097/MD.0000000000016600.
Werner MU. Management of persistent postsurgical inguinal pain. Langenbecks Arch Surg. 2014 Jun;399(5):559-69. doi: 10.1007/s00423-014-1211-9. Epub 2014 May 23.
Bischoff JM, Enghuus C, Werner MU, Kehlet H. Long-term follow-up after mesh removal and selective neurectomy for persistent inguinal postherniorrhaphy pain. Hernia. 2013 Jun;17(3):339-45. doi: 10.1007/s10029-013-1073-z. Epub 2013 Mar 15.
Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005 Jul;92(7):795-801. doi: 10.1002/bjs.5103.
Aasvang EK, Kehlet H. The effect of mesh removal and selective neurectomy on persistent postherniotomy pain. Ann Surg. 2009 Feb;249(2):327-34. doi: 10.1097/SLA.0b013e31818eec49.
Linderoth G, Kehlet H, Aasvang EK, Werner MU. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair. Hernia. 2011 Oct;15(5):521-9. doi: 10.1007/s10029-011-0815-z. Epub 2011 Apr 9.
Other Identifiers
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H-2-2011-023-FE
Identifier Type: -
Identifier Source: org_study_id
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