Lichtenstein repair of indirect inguinal hernias with acellular tissue matrix grafts in adolescent patients: a prospective, randomized, controlled trial

Shen, Yingmo; Chen, Jie; Tian, Ming; Yang, Shuo; Liu, Sujun; Wang, Minggang

doi:10.1007/s00595-013-0550-4

Cited by 15 publications

(21 citation statements)

References 35 publications

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“…A prospective trial performed comparing adolescent high ligation repair with a Lichtenstein hernioplasty using acellular tissue matrix mesh repair demonstrates longer operative times with mesh repair, but no significant difference was found in recurrence rate with a follow-up of 30 months. 6 However, the reverse principles of applying pediatric surgical methods to adults have not been studied.…”

Section: Discussionmentioning

confidence: 99%

“…Postpubertal adolescents have similar anatomy to the adult population with a larger internal inguinal ring diameter and variations on transverse fascia defects. 6 Inguinal hernia repair in adults is also the most commonly performed surgical procedure for an adult general surgeon. 7 However, adult herniorrhaphy is most often performed with mesh placement because of concerns that high ligation alone would have a higher recurrence rate.…”

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confidence: 99%

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Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

Gasior

Knott

Kanters

et al. 2015

The American Surgeon

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High ligation of the inguinal hernia sac is standard practice for many pediatric surgeons in post-pubertal adolescents. Most adult surgeons do not use this technique to repair indirect inguinal hernias because of concerns for higher recurrence rates compared with mesh repairs. Therefore, we examined long-term outcomes of adolescent high ligation hernia repair performed by pediatric surgeons. Telephone surveys were conducted on children over 12 years old at the time of repair, and patients and/or their parents were contacted 18 months postrepair. Patients were identified from two institutions between 1998 and 2010. The incidences of reoperation, recurrence, presence of bulge, chronic pain, or numbness were determined. A total of 210 patients (40.7% response rate) were available for phone interviews at 18.6 to 159.5 months postrepair. Mean age was 14.6 ± 1.8 (range: 12.0–19.0 years). Fourteen patients had pain (6.7%) and five had numbness (2.4%). There were four (1.9%) patients with a second operation, two of which confirmed a recurrent hernia. Three patients expressed concern about possible recurrence. Two report a bulge, but have not been evaluated. Pediatric hernia repair with high sac ligation appears effective in patients anatomically similar to adults with low recurrence rate and low incidence of chronic symptoms. These data suggest that prospective trials on the adequacy of high ligation in adults are warranted.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

Gasior

Knott

Kanters

et al. 2015

The American Surgeon

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“…et al[18] have done a comparative study of the high ligation of the laparoscopic hernia sac and the posterior wall repair in the adolescent indirect hernia. The size of the internal ring diameter in the two groups was 2.37 ± 0.52 (1.60-3.62) cm VS 2.41 ± 0.58 (1.59-3.65) cm (p = 0.592).The results showed that the recurrence rate in high ligation group(4/115,3.48%) was higher than that in posterior wall suture repair group (0/129,0%) (p = 0.048).Shen Yingmo et al [22]have done a prospective comparative study between high ligation and Lichtenstein hernioplasty using acellular tissue matrix (ACTM) grafts in adolescent patients. the diameter of the two groups was 2.2 ± 0.5cm vs2.3 ± 0.5cm(p = 0.499) ,The results showed that the recurrence rate no difference between the two groups6% (3/50) vs0% (0 / 50) (p = 0.079), but subgroup (the patients with Gilbert type 3 hernias)analysis found that the recurrence rate of high ligation group was higher than mesh repair group.…”

Section: Discussionmentioning

confidence: 92%

“…From the current literature [18,22],the conclusion seems to be drawn. the diameter of internal ring more than 3cm or severe transverse fascia defect of adolescent indirect hernias were recommended to use mesh repair, when the diameter of internal ring between 2-3cm ,the e cacy of high hernia sac ligation was controversial, these patients can be considered laparoscopic posterior wall suture repair or open muscle repair.…”

Section: Discussionmentioning

confidence: 94%

Analysis of the efficacy of high hernia sac ligation in adolescent indirect hernia

Fan

Yao

2023

Preprint

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Objective To evaluate the efficacy of high hernia sac ligation in adolescent indirect hernia. Methods The data of adolescent patients underwent high hernia sac ligation in the The First People's Hospital of Foshan,China from January 2012 to December 2019 were analyzed retrospectively, mainly collecting their age, gender, weight, surgical method, the hernia ring diameter, operation time, postoperative recurrence rate and postoperative complications. Results A total of 71 patients were enrolled, including 62 males (87.32%) and 9 females (12.68%),all patients aged 13–18 years old (mean14.90 ± 1.57years), weighing 28-92kg (mean 53.08 ± 10.53kg), 70patients underwent laparoscopic surgery except 2 with irreducible hernias converted to laparotomy,1 patients underwent open hernia sac high ligation.the hernia ring diameter: 0.5-3cm (mean 1.39 ± 0.49cm), and the diameter of the hernia ring ≤ 2cm in 69 cases (97.18%),The operative length: 12-105min (average 25.45 ± 13.19min), There were 38(53.5%) right-sided hernias, 32 (45.1%) leftsided hernias, 1 (1.4%) performed simultaneous bilaterally.There were 68 (95.8%)reducible hernia,2(2.8%)irreducible hernias ,1(1.4%)incarcerated hernia,Hospital stay :1–5 days (mean 2.37 ± 1.04 days), Follow-up 24-119months (mean 73.56 ± 28.56months), no recurrence, one case of incision infection occured, A second operation was performed 6 months after the operation,4(5.6%)patients had complaints of intermittent pain around the ligation incision site mostly during exerciseIn . Conclusion High hernia sac ligation is feasible for treat indirect hernia with a diameter of the hernia ring ≤ 2cm.

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“…According to the results of our clinical study [18], the authors found that the simple high hernia sac ligation is inadequate for adolescents (13 to 18 years old) with a longer medical history, larger diameter of internal inguinal ring, and more serious transverse fascia defects. The inguinal hernia treated with simple high hernia sac ligation in adolescents is prone to postoperative recurrence; therefore, the procedure, similar to the treatment of adult inguinal hernia, should be taken, for example, repairing the transverse fascia and strengthening of the posterior wall of the inguinal canal.…”

Section: Indications For Surgerymentioning

confidence: 99%

Individualized Treatment of Inguinal Hernia in Children

Chen¹,

Chu²,

Shen³

et al. 2017

Hernia

Self Cite

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The incidence of inguinal hernias in various age groups of children ranges from 0.8 to 4.4%. Pediatric indirect inguinal hernia is congenital, originating in the patent processus vaginalis. The inguinal hernia repair is one of the most common pediatric operations. The traditional high hernia sac ligation is the primary treatment for younger patients from 1 to 13 years of age and can correct the condition. The authors performed the high ligation of the hernia sac by the laparoscopic approach for the patients under 13 years old and achieved good therapeutic results in the last 10 years. However, through our clinical study, the authors found that the simple high ligation of hernia sac is inadequate for patients from 13 to 18 years of age, who had a longer medical history, larger diameter of the internal inguinal ring, and more serious defects of the transverse fascia. Pediatric inguinal hernias are prone to postoperative recurrence if the patients were only treated with the high ligation of hernia sac. To repair the transverse fascia and strengthen the posterior wall of the inguinal canal, Lichtenstein hernioplasty with a biological patch was performed for the patients from 13 to 18 years in the authors' department. The aims of this chapter are to narrate the individualized treatment of inguinal hernia in children and try to provide relatively reasonable operative methods.

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Lichtenstein repair of indirect inguinal hernias with acellular tissue matrix grafts in adolescent patients: a prospective, randomized, controlled trial

Abstract: Lichtenstein hernioplasty using ACTM grafts has comparable safety and efficacy to traditional high ligation of the indirect hernia sac in adolescent patients. ACTM can reduce the incidence of recurrence in adolescents with Gilbert type 3 hernias.

Cited by 15 publications

References 35 publications

Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

Analysis of the efficacy of high hernia sac ligation in adolescent indirect hernia

Individualized Treatment of Inguinal Hernia in Children

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