Laparoscopic vs. Open Repair Surgery for the Treatment of Communicating Hydrocele in Children: A Retrospective Study From a Single Center

Abstract

Purpose: This study evaluated the outcomes of laparoscopic repair (LR) and open repair (OR) surgery for communicating hydrocele in children.Patients and Methods: We collected the clinical data and follow-up data of all boys (<14 years) who underwent communicating hydrocele surgery in the pediatric surgery department at Yijishan Hospital of Wannan Medical College from January 2017 to December 2018 and retrospectively analyzed the data.Results: In this study, 155 patients were retrospectively enrolled, including 90 patients in the OR group and 65 patients in the LR group. There were significant differences in operation time and the recurrence of hydrocele between the two groups. The persistence of scrotal swelling in the LR group was significantly lower than that in the OR group. There was no significant difference in postoperative hospitalization time or incision infection rate between the two groups.Conclusion: In conclusion, this study shows that laparoscopic treatment of children with communicating hydrocele has the advantages of a hidden incision, a shortened operation time, and a reduced postoperative recurrence rate and can be used as the preferred surgical method. However, laparoscopic treatment should be selected according to the specific condition of each child and cannot completely replace traditional open surgery.

Comparison of Percutaneous Internal Ring Suturing (PIRS) versus Open Ligation of the Patent Processus Vaginalis for the Treatment of Communicating Pediatric Hydrocele

“…In the study by Elhaddad et al, there was also no evidence of recurrent hydrocele or testicular atrophy in any of the cases [5]. However, the study by Liu et al showed a significantly higher recurrence rate in the OR group than in the LR group (6.67% vs. 0%, p = 0.034) [13]. In the study by Zhang et al, 9 recurrences (1.1%) occurred in the 950 laparoscopic procedures, which did not differ significantly from the 5 cases in the open repair group (1.3%) [8].…”

“…All postoperative complications were treated conservatively. However, the study by Liu et al showed a significantly higher persistence of scrotal swelling in the OR group than in the LR group (10% vs. 1.54%, p = 0.034) [13]. Zhang et al also reported a significantly higher incidence of scrotal edema in the OR group than in the LR group (71 (18.6%) vs. 0, p < 0.01).…”

“…This technique feels easier than laparoscopic hernia repairs because, unlike children with inguinal hernias, the peritoneum is usually not thickened and is easier to dissect from the spermatic elements [8]. Most of the previous studies favor single-port single-incision laparoscopic treatment of hernias and hydroceles [5,[11][12][13]. Although for certain conditions the laparoscopic approach still cannot completely replace traditional open surgery, advocates of laparoscopic techniques believe that, over time, open approaches will become fewer and fewer [12,14,15].…”

A Review of Classification, Diagnosis, and Management of Hydrocele

“…This collection can be regressed or persistent. [17][18][19][20] Figure 6. A 27-year-old male patient presents with swelling of the bilateral scrotum and left lower abdomen, accompanied by persistent dull pain.…”

“…Note that if the processus vaginalis is not ligation, it can lead to postoperative fluid collection (Figure 9). This collection can be regressed or persistent 17–20 …”