Ilioinguinal Nerve Neurectomy versus Preservation in Lichtenstein Hernia Repair: A Systematic Literature Review and Meta-Analysis

Abstract

Introduction: Hernias may be defined as “an abnormal protrusion of an organ or tissue through a defect in itssurrounding walls.”Aim of work: To evaluate the incidence of chronic groin pain and sensational alterations after Lichtensteininguinal hernia repair, comparing neurectomy with ilioinguinal nerve preservation surgery.Patients and methods: This systematic review included studies after 2010. A total of 1441 relevant studies wereobtained from the initial search. After screening of the titles and abstracts according to the inclusion and exclusioncriteria, the full text was further read, and ultimately, 10 studies were included.Result: The study found that neurectomy patients experienced significantly lower postoperative pain comparedto preservation patients, with a pooled risk ratio of nearly four times lower. The neurectomy group requiredlower analgesia compared to the preservation group, with a significant decrease observed at the seventh daypostoperative. Neuroctomy patients experienced significantly lower analgesia duration compared to preservationpatients. The preservation group experienced higher but not statistically significant numbness compared to theneurectomy group, with no significant difference observed at the first day postoperative. The preservation groupexperienced higher hypothesia compared to the neurectomy group, with a significant increase at the first daypostoperative.Conclusion: The neurectomy of the ilioinguinal nerve during Lichtenstein hernia repair significantly reducedpostoperative pain, analgesia requirement, and groin numbness and hypoesthesia, especially on the first day postsurgery.However, the results were not significant due to the small number of cases. It is now recommended thatsurgeons discuss the uncertain benefits and potential risks of neurectomy with patients and their families beforeperforming hernioplasty.