Outcomes of Adolescent and Young Adults Receiving High Ligation and Mesh Repairs: A 16-Year Experience

Criss, Cory N.; Gish, Nathan; Gish, Joshua; Carr, Benjamin; McLeod, Jennifer S.; Church, John; Hsieh, Lily B.; Matusko, Niki; Geiger, James D.; Hirschl, Ronald B.; Gadepalli, Samir K.

doi:10.1089/lap.2017.0511

Cited by 17 publications

(18 citation statements)

References 32 publications

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“…After 24-119months (mean 73.56 ± 28.56months)of follow-up, the results showed the recurrence rate was 0%. some other studies have shown that the recurrence rate of high hernia sac ligation without mesh for adolescent hernias was 0.95%-3.5%, which was also relatively low [7,18].The recurrence rate of high ligation for adolescent hernias was similar to that of mesh repair for adult hernias [19].Another study reported that the recurrence rate of patients aged 18-25 years who underwent herniectomy without mesh placement or posterior wall repair is 0% [20]. These suggests that high hernia sac ligation without mesh placement or posterior wall repair is effective enough in treating adolescent hernias.However, none of these studies showed the size of the deep ring of the indirect hernia, as the size of the internal ring may affect the choice of the surgeon [17,21].The internal ring is small, the surgeon chooses the hernia sac high ligation more, the internal ring is large, and the surgeon chooses the mesh repair or tissue repair more.So how large the internal ring should the surgeon select mesh repair or tissue repair?How small select a simple high hernia sac ligation?…”

Section: Discussionmentioning

confidence: 83%

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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Section: Discussionmentioning

confidence: 83%

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

Fan

Yao

2023

Preprint

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“…Two randomized controlled trials [ 34 , 37 ], six prospective cohort studies [ 26 , 38 – 40 , 43 , 44 ] and 13 retrospective cohort studies [ 27 – 33 , 35 , 36 , 41 , 42 , 45 , 46 ] with data on a total of 3,816 adolescent patients with 3,953 groin hernia repairs were included. Overall, there were 3,200 non-mesh and 753 mesh repairs.…”

Section: Resultsmentioning

confidence: 99%

Low incidence of recurrence and chronic pain after groin hernia repair in adolescents: a systematic review and meta-analysis

Reistrup

Andresen

Rosenberg

2023

Langenbecks Arch Surg

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Purpose The best operative management of groin hernia in adolescents is uncertain. The aim of this systematic review was to assess recurrence and chronic pain after mesh versus non-mesh repair for groin hernia in adolescents. Methods A systematic search was done in PubMed, EMBASE, and Cochrane CENTRAL in May 2022 for studies reporting postoperative chronic pain (≥6 months) or recurrence after groin hernia repair in adolescents aged 10–17 years. We included randomized controlled trials and observational studies on primary unilateral or bilateral groin hernia repair. Risk of bias was assessed with the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale. Meta-analysis of the incidence of recurrence was conducted. This review is reported according to PRISMA guideline. Results A total of 21 studies including 3,816 adolescents with groin hernias were included comprising two randomized controlled trials, six prospective, and 13 retrospective cohort studies. For non-mesh repairs, the weighted mean incidence proportion of recurrence was 1.6% (95% CI 0.6–2.5) after 2,167 open repairs and 1.9% (95% CI 1.1–2.8) after 1,033 laparoscopic repairs. For mesh repairs, it was 0.6% (95% CI 0.0–1.4) after 406 open repairs while there were no recurrences after 347 laparoscopic repairs (95% CI 0.0–0.6). Across all surgical techniques, the rate of chronic pain after 1,153 repairs ranged from 0 to 11%. Follow-up time varied and was reported in various ways. Conclusion The incidences of recurrence after groin hernia repair in adolescents were low for both open and laparoscopic mesh and non-mesh repairs. Rates of postoperative chronic pain were low. Trial registration PROSPERO: CRD42022130554.

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“…4,6,9,14 Previous reports have revealed a similar or lower hernia recurrence after mesh repair in young adults than those without mesh. 4,6,13,14,17 Tanaka et al reported that high ligation of a hernia orifice is insufficient for all young adult patients. 6 However, laparoscopic high ligation has some merits, such as cosmetic advantages, less peritoneal damage, and a lack of mesh complications, and it is easy to repair an inguinal hernia recurrence after a laparoscopic high ligation procedure.…”

Section: Resultsmentioning

confidence: 99%

“…After laparoscopic high ligation in adolescents and young adults, recurrence is 0%–5.9% 4,6,9,14 . Previous reports have revealed a similar or lower hernia recurrence after mesh repair in young adults than those without mesh 4,6,13,14,17 . Tanaka et al.…”

Section: Discussionmentioning

confidence: 96%

The outcome of closure of inguinal hernia with laparoscopic percutaneous extraperitoneal closure in young adults

Tanaka,

Miyaki,

Abe

et al. 2023

World j. surg.

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BackgroundHernioplasty is one of the most commonly performed surgeries. However, the optimal procedure for young adults has not been defined yet. Our study compared the outcomes of laparoscopic percutaneous extraperitoneal closure (LPEC) in young adults with outcomes in children.Material and MethodsWe retrospectively reviewed patients aged 0–30 years who underwent LPEC. Data regarding age, sex, hernia type, surgical time, pre‐intraoperative laterality, contralateral patent processus vaginalis (CPPV), and complications were analyzed.ResultsLPEC was performed on 2642 patients in our hospital. Of these, 51 patients were young adults (aged 15–30 years). Asymptomatic CPPV in unilateral patients was frequent in the <15‐year age group (50.2%) compared to the 15–30‐year age group (15.9%). The median surgical time was shorter in the <15‐year age group (19 min, interquartile range [IQR]: 24–33) compared to that of the 15–30‐year age group (33 min, IQR: 23.3–40.8).ConclusionsThis is the first report on the outcomes in young adult patients who underwent LPEC. The median surgical time was longer in the 15–30‐year age group than in the <15‐year age group. The median follow‐up was 4.7 years with no intra‐postoperative complications, such as postoperative bleeding, infection, persistent pain, and recurrence. LPEC is an effective, cosmetic, and safe surgical treatment in young adults and children.

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Outcomes of Adolescent and Young Adults Receiving High Ligation and Mesh Repairs: A 16-Year Experience

Abstract: In adolescents and young adults, the long-term recurrence rate after inguinal hernia repair is ∼6% with time to recurrence approaching 4 years. Outcomes of high ligation and mesh repair are similar, highlighting the need for individualized approaches for this unique population.

Cited by 17 publications

References 32 publications

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

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

Low incidence of recurrence and chronic pain after groin hernia repair in adolescents: a systematic review and meta-analysis

The outcome of closure of inguinal hernia with laparoscopic percutaneous extraperitoneal closure in young adults

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