Efficacy of Laparoscopic Percutaneous Extraperitoneal Closure for Unilateral Inguinal Hernia in Children and Significance of Simple Exploration Maneuver for Contralateral Patent Processus Vaginalis: A Retrospective Study

Abstract

To evaluate the efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) for unilateral inguinal hernia in children and effect of intraoperative laparoscopic exploration for finding contralateral patent processus vaginalis (CPPV) on prevention of the metachronous contralateral hernia (MCH). We retrospectively analyzed unilateral inguinal hernia ligation in children, which can be diveded into two groups: a total of 252 cases with open surgical ligation from January 2010 to December 2012 (open group), a total of 184 cases underwent laparoscopic percutaneous peritoneal hernia sac high ligation LPEC from January 2013 to March 2015 (LPEC group). Then, we observed postoperative complications, recurrence of hernia, and the postoperative MCH in the two groups and analyzed the influence factors of the MCH. In Open groups and LPEC groups, the complication incidences, respectively, were 4.4 and 1.6 per cent, having statistical difference ( P > 0.05), the average postoperative follow-up duration, respectively, were 42 months and 22 months, whereas the overall incidence of MCH, respectively, were 5.2 and 0.5 per cent ( P < 0.05). In the first 24 months follow-up time, the overall incidence of MCH, respectively, were 3.6 and 0 per cent. Laparoscopic evaluation was positive for CPPV in 67 cases. We found the prevalence of 56.1 per cent of CPPV in LPEC groups aged 0.6 to 2 years old, finding the incidence gradually decline with the increase of age, until 14.3 per cent to 10 to 12 years old group. Our study shows LPEC has proven efficacy in treatment of unilateral inguinal hernia in children, and routine laparoscopic exploration with this simple maneuver should be actively performed to observe CPPV in all chidren.

Analysis of Contralateral Patent Processus Vaginalis in Laparoscopic High Ligation of the Vaginal Process and Clinical Long-term Effect of Individualized Treatment

“…Laparoscopy can enlarge the visual field and observe CPPV more intuitively. It has become an ideal tool for intraoperative diagnosis of CPPV with its high sensitivity and specificity (16). We intraoperatively explored the contralateral side of 300 children and found 111 cases of CPPV.…”

Effects of TAPP Combined with Biological Mesh on Reproductive Function in Male Inguinal Hernia Patients of Reproductive Age: A Single-Center Retrospective Study

“…Inguinal hernia is a common and frequently occurring disease in general surgery, and the incidence of male is significantly higher than that of female [1]. Surgery is the only way to cure inguinal hernia.…”