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Inicio Cirugía Española (English Edition) Chronic postoperative inguinal pain: A narrative review
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Vol. 99. Issue 2.
Pages 80-88 (February 2021)
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Vol. 99. Issue 2.
Pages 80-88 (February 2021)
Special article
DOI: 10.1016/j.cireng.2021.01.017
Chronic postoperative inguinal pain: A narrative review
Dolor inguinal crónico posquirúrgico. Una revisión narrativa
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Raúl Medina Velázquez
Corresponding author
raul.medvel@gmail.com

Corresponding author.
, Joaquín Marchena Gómez, María José Luque García
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
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Table 1. Risk factors for the development of postoperative chronic pain.
Table 2. Intraoperative measures to prevent the appearance of CPIP proposed by Amid et al.
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Abstract

Inguinodynia or chronic postoperative inguinal pain is a growing problem between patients who undergo surgical repair of an inguinal hernia. The change in results measurement proposed by many authors towards Patient Reported Outcome Measurement has underlined the importance of chronic postoperative inguinal pain, because of the great limitations in everyday life and the huge socioeconomic impact that it causes. In this article a narrative review of the available literature is performed and the most relevant aspects about epidemiology, etiology prevention, diagnosis and treatment of chronic postoperative inguinal pain are discussed. A new management algorithm is also proposed. The variability in its incidence and clinical presentation makes diagnosis of chronic postoperative inguinal pain a very challenging issue. There is no standardized therapy and an adequate etiological diagnosis is key point for a successful treatment. There are many treatment options that have to be sequentially used and adjusted to each patient and their clinical features.

Keywords:
Chronic postoperative inguinal pain
Epidemiology
Etiology
Prevention
Diagnosis
Treatment
Management
Algorithm
Resumen

El dolor inguinal crónico posquirúrgico constituye una complicación de incidencia variable entre los pacientes intervenidos de hernia inguinal. La tendencia actual de medición de resultados en términos de calidad de vida (patient reported outcome measurement) ha puesto de manifiesto la importancia de esta complicación, debido a las limitaciones de actividad diaria e implicaciones socioeconómicas que genera. En este artículo se realiza una revisión narrativa de la literatura disponible en las plataformas PUBMED, EMBASE y Cochrane Library y se discuten los principales aspectos concernientes a la epidemiología, etiología, prevención, diagnóstico y tratamiento del dolor inguinal crónico posquirúrgico, proponiéndose un algoritmo para su manejo. Los pacientes que padecen dolor inguinal crónico posquirúrgico presentan un amplio espectro de manifestaciones clínicas y su diagnóstico supone un auténtico desafío. No existe un tratamiento estándar y el éxito del mismo radica en un adecuado diagnóstico etiológico para poner a disposición del paciente el amplio abanico de medidas terapéuticas de las que se dispone de forma individualizada.

Palabras clave:
Dolor inguinal crónico posquirúrgico
Inguinodinia
Epidemiología
Etiología
Prevención
Diagnóstico
Manejo
Algoritmo

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