Evaluation of chronic pain after transabdominal preperitoneal hernia repair

Background: Early postoperative pain after transabdominal preperitoneal hernia repair (TAPP) has been frequently reported. However, the incidence and degree of chronic pain after TAPP have not been evaluated. Therefore, author aimed to examine chronic pain after TAPP. Methods: A total of 256 who underwent TAPP between November 2008 and March 2015 at the institute were enrolled. Original questionnaires focusing on the current state of pain were sent to the enrolled patients by mail. The incidence, body location, and degree of chronic pain occurring at least 6 months after the initial surgery were evaluated. In addition, a medical chart review of patients with and without chronic pain was performed to determine the predictive factors of chronic pain. Results: The survey response rate was 43.8% (112/256). The median follow-up period after the initial surgery was 44.3 months (range, 9.7-80.3 months). Sixty percent of patients experienced pain after TAPP; however, in 56.2% of the patients, the pain had mitigated 1 week after TAPP. Ten percent (12/112) of the patients had chronic pain 6 months after TAPP. Pain in the inguinal region was more frequently reported than any other wound region (67% vs 25%, p =0.0009). Although most of the patients with pain felt the pain occasionally, three of twelve patients (25%) complained of daily pain and had high VAS score. No significant predictive factors of chronic pain were identified. Conclusions: Ten percent of patients experienced chronic pain after TAPP. Large scale prospective trials are needed to identify the predictive factors of chronic pain.