Postoperative inguinal pain and disability after Lichtenstein versus ONSTEP hernia repair: analysis of responses to the
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ORIGINAL ARTICLE
Postoperative inguinal pain and disability after Lichtenstein versus ONSTEP hernia repair: analysis of responses to the inguinal pain questionnaire in Spanish Jorge Aguilar‑García1,2 · Rodrigo Villafuerte‑Fernandez1 · Perla I. Ntezes‑Hidalgo1 · Jose A. Meade‑Aguilar1 · Jose L. Ramirez‑GarciaLuna2,3 · Mario A. Martinez‑Jimenez1,2 Received: 20 April 2020 / Accepted: 19 August 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose To validate the Inguinal Pain Questionnaire (IPQ) in the Spanish Language and test its use in a randomized controlled trial (RCT) of hernia repair using the Lichtenstein technique vs. the ONSTEP technique. We simplified the IPQ using a principal component analysis (PCA) approach as a secondary objective. Methods The IPQ was translated into Spanish and validated in a cohort of 21 patients. Thereafter, 40 patients were randomized to undergo hernia repair by the Lichtenstein technique or the ONSTEP technique. IPQ and pain visual analogue (VAS) score trends over time were compared using a repeated-measures mixed-effects model. Results The Spanish version of the IPQ showed an internal consistency similar to that of the original score. No significant differences were found in the IPQ responses, pain VAS, or the rate of self-reported pain between patients who underwent the Lichtenstein technique and those who underwent the ONSTEP technique. Following PCA analysis, the number of items on the IPQ was reduced from 18 to 10. Conclusions The Spanish version of the IPQ measures postoperative inguinal pain adequately. Based on our findings, the ONSTEP technique was not superior to the Lichtenstein technique. The simplified version of the IPQ is not significantly different from the full version and it is easier to complete. Clinical trial registration NCT04138329, registered on October 24, 2019. Keywords Inguinal hernia · ONSTEP · Lichtenstein · Postoperative inguinal pain · Validation studies
Introduction
Ramirez-GarciaLuna Jose L. and Martinez-Jimenez Mario A. contributed equally to the supervision of the study. * Jose L. Ramirez‑GarciaLuna [email protected] 1
Division of General Surgery, Hospital Central “Dr. Ignacio Morones Prieto”, 2395 Venustiano Carranza Ave., 78290 San Luis Potosi, SLP, Mexico
2
Department of Surgery, Faculty of Medicine, Universidad Autonoma de San Luis Potosi, 2405 Venustiano Carranza Ave., 78210 San Luis Potosi, SLP, Mexico
3
Division of Experimental Surgery, Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montréal, QC H3G 2M1, Canada
Inguinal hernias are the most common hernias requiring surgical repair, which is performed traditionally in the Western world via an open approach with a mesh implant [1, 2]. Because of the routine use of mesh in inguinal repair, hernia recurrence has diminished considerably. Now, more emphasis is placed on promoting the patient’s quality of life by improving functional outcomes and minimizing postoperative inguinal pain [3, 4]. The most common hernia mesh re
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