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Incidence of Cord Hydrocele After Laparoscopic Intracorporeal Inguinal Hernia Repair in Male Pediatric Patients: A Comparative Study Between Removing and Leaving the Hernial Sac.

08:00 EDT 24th March 2020 | BioPortfolio

Summary of "Incidence of Cord Hydrocele After Laparoscopic Intracorporeal Inguinal Hernia Repair in Male Pediatric Patients: A Comparative Study Between Removing and Leaving the Hernial Sac."

Many laparoscopic repair techniques are available for treating pediatric inguinal hernias. The development of a cord hydrocele (CH) after laparoscopic pediatric inguinal hernia repair (LPIHR) in male patients can lead to reoperation. We performed the present study to evaluate the effects of hernial sac removal on the occurrence of CH after laparoscopic transabdominal inguinal hernia repair in male patients. This retrospective study included 3145 male pediatric patients aged <10 years who underwent LPIHR from January 2014 to March 2017. We categorized patients into two groups according to the operative technique: Group 1 (high ligation without hernial sac removal, 1592 patients) and Group 2 (high ligation with hernial sac removal, 1553 patients). We removed the hernial sacs in the first half of the study period and not in the second half of the study period. We analyzed the surgical outcomes in both groups after the same follow-up period of ≥2.5 years. We found no significant differences in demographic or clinical parameters between the treatment groups. CH occurred in 6 patients in Group 1 only; no patients in Group 2 developed CH (0.38% [6/1592] versus 0.00% [0/1553], respectively;  = .044). The interval from the initial hernia repair to the hydrocelectomy in 6 patients was 20.8 months. The recurrence rate was higher in Group 1 (0.4%, 7/1592) versus Group 2 (0.0%, 0/1553) ( = .025). In the logistic regression test, Group 2 predicted a lower CH occurrence rate than Group 1 (odds ratio = 1.004, 95% confidence interval = 1.001-1.007;  = .016). Our findings indicated that hernial sac removal resulted in a small but significant decrease in the risk of postoperative CH.

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This article was published in the following journal.

Name: Journal of laparoendoscopic & advanced surgical techniques. Part A
ISSN: 1557-9034
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Medical and Biotech [MESH] Definitions

An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.

A protrusion of abdominal structures through the retaining ABDOMINAL WALL. It involves two parts: an opening in the abdominal wall, and a hernia sac consisting of PERITONEUM and abdominal contents. Abdominal hernias include groin hernia (HERNIA, FEMORAL; HERNIA, INGUINAL) and VENTRAL HERNIA.

A groin hernia occurring inferior to the inguinal ligament and medial to the FEMORAL VEIN and FEMORAL ARTERY. The femoral hernia sac has a small neck but may enlarge considerably when it enters the subcutaneous tissue of the thigh. It is caused by defects in the ABDOMINAL WALL.

Either of a pair of tubular structures formed by DUCTUS DEFERENS; ARTERIES; VEINS; LYMPHATIC VESSELS; and nerves. The spermatic cord extends from the deep inguinal ring through the INGUINAL CANAL to the TESTIS in the SCROTUM.

The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring.

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