Ten year experience of laparoscopic repair of pediatric hydrocele and the long-term follow-up results

Yang, Xiaodong; Wu, Yang; Xiang, Bo; Wong, Kenneth K. Y.; Pei, Jiao; Li, Fuyu

doi:10.1016/j.jpedsurg.2015.07.007

Cited by 15 publications

(12 citation statements)

References 24 publications

(27 reference statements)

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“…Laparoscopy has been used to treat hydroceles, because the method has been widely applied in inguinal hernia repair in children. The surgical principle of laparoscopic treatment of PPV is the anatomical closure of the PPV [ 1 , 6 ], which is consistent with the treatment of inguinal hernias in children as indicated in previous studies at several centres evaluating the feasibility and safety of the technique [ 8 – 12 ]. Surgeons have stated that laparoscopic surgery is only indicated for communicating hydroceles.…”

Section: Discussionmentioning

confidence: 71%

“…In adults, secretions of the tunica vaginalis often cause hydroceles. Therefore, the surgical technique for hydroceles in children differs from that in adults, and good efficacy can be achieved as long as the open PPV is closed [6]. Fluid within the cyst can be removed by aspiration or simply left in place [7].…”

Section: Discussionmentioning

confidence: 99%

“…Surgeons have stated that laparoscopic surgery is only indicated for communicating hydroceles. However, in a 10-year experience and follow-up report of laparoscopic repair of hydroceles by Yang et al [6], 283/284 patients (99.6%) in their case series were discovered with open internal rings and PPV instead of closed internal rings. In our study, open PPV was found at the internal ring orifice in 98.53% of patients during laparoscopic surgery and ideal efficacy was achieved following the closure of the internal ring and percutaneous aspiration through the scrotum.…”

Section: Discussionmentioning

confidence: 99%

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Does the laparoscopic treatment of paediatric hydroceles represent a better alternative to the traditional open repair technique? A retrospective study of 1332 surgeries performed at two centres in China

zhang

Chao

Zhang

et al. 2017

Hernia

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PurposeTo evaluate the safety, efficacy and merits of laparoscopic repair in children with hydroceles by comparing the outcomes of laparoscopic repair and the traditional open repair (OR) procedure. The outcomes of the following three laparoscopic percutaneous extra-peritoneal closure (LPEC) approaches were also compared: conventional two-port surgery, transumbilical single-site two-port surgery and single-port surgery.MethodsWe retrospectively compared the demographic, perioperative and follow-up data from the consecutive records obtained for 382 boys who underwent OR and 950 boys who underwent LPEC at two children’s medical centres in China. In the LPEC group, regardless of the hydrocele form, one of the three approaches with percutaneous aspiration was performed: conventional two-port surgery was performed in 387 cases, single-site two-port surgery was performed in 468 cases and single-port surgery was performed in 95 cases. The clinical data and complications were statistically analysed.ResultsPostoperative follow-up data were obtained for all the patients. The mean follow-up time was 36 months (24–48 months) in the OR group and 32.5 months (20–44 months) in the LPEC group. Significant differences in recurrence were not observed between the groups (five in the OR and 10 in the LPEC; P = 0.69). However, the operation time, postoperative hospital stay, incidence of scrotal oedema, incision infection and contralateral metachronous hernia or hydrocele were significantly higher in the OR group than those in the LPEC group (P < 0.01). Eighteen children (4.71%) had a negative exploration of the patent processus vaginalis (PPV) in the OR group. Fourteen children (1.47%) in the LPEC group had a closed internal ring and were converted to a scrotal procedure. Significant differences in the clinical data or complications were not observed between the two centres for the laparoscopic procedure (P > 0.05). Contralateral PPV (cPPV) was found in 18 patients in the single-port group (18.9%). Of the patients affected with cPPV, significant differences were observed between the single-port group and the two-port LPEC group (122 patients, 31.5%, P = 0.016) and the single-site two-port group (the 148 patients, 31.6%, P = 0.013). A contralateral metachronous hernia or hydrocele was found in zero, zero and two cases in these groups, respectively, and significant differences were observed (P < 0.01) between the single-site surgery and the other two laparoscopic approaches.ConclusionsLPEC is safe, feasible and effective for treating hydroceles in children and has the same recurrence rate as OR. However, LPEC is superior in operation time, hospital stay, occurrence of scrotal oedema, incision infection and occurrence of metachronous hernia or hydrocele. The transumbilical single-site two-port procedure has the same cosmetic effect as the single-port LPEC. According to our experience, the two-port LPEC approach is better for diagnosing cPPV and reducing metachronous hernia or hydrocele than the single-port LPEC procedure.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does the laparoscopic treatment of paediatric hydroceles represent a better alternative to the traditional open repair technique? A retrospective study of 1332 surgeries performed at two centres in China

zhang

Chao

Zhang

et al. 2017

Hernia

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“…Наряду с традиционными методами лечения гидро-целе некоторые урологи, особенно в детской практике, используют видеоэндоскопические операции [18,19].…”

Section: оперативные методы лечения гидроцелеunclassified

Sclerotherapy of hydrocele with ethanol (a literature review)

Кадыров¹,

Olimov²

2017

Androl. genit. hir.

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“…In recent years, laparoscopic percutaneous extraperitoneal closure has been considered a routine treatment for hydrocele and inguinal hernia in many medical centers (9)(10)(11)(12). Compared with traditional inguinal repair, the processus, if patent, is dilated via pneumoperitoneum, and magnifying the area using laparoscopy makes it easier to distinguish the orientation of the processus (10).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Detection and Ligation of Patent Processus Vaginalis Between Laparoscopy-Assisted Transscrotal Orchiopexy and Single Scrotal Incision Orchiopexy

Zhao

2022

Front. Surg.

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This study aimed to compare the detection and ligation of patent processus vaginalis (PPV) between laparoscopy-assisted transscrotal orchidopexy (LATO) and single scrotal incision orchiopexy (SSIO) for low palpable undescended testis (UDT). We performed a retrospective medical record review of transscrotal orchidopexies performed for low palpable UDT at our institution from 2017 to 2019; 33 and 39 boys underwent LATO and SSIO, respectively. Data collection included patient demographics, incidence of PPV, operative time, and clinical outcomes. All 95 testes were delivered into the scrotum. There was no significant difference between the two groups with respect to patients' age, side, and mean operative time. The incidence of PPV in the LATO group was significantly higher than that in the SSIO group (56.52 vs. 34.69%, P = 0.04). The incidence of contralateral PPV in the LATO group was 45%. One patient in the SSIO group underwent unilateral PV ligation and laparoscopic exploration revealed bilateral PPV owing to metachronous contralateral hydrocele. One patient in the LATO group demonstrated obliterated PV in the initial transscrotal procedure, but an ipsilateral PPV was found in the latter laparoscopic procedure. In conclusion, LATO has a higher detection rate and higher ligation of the PPV than SSIO, suggesting that, LATO may help reduce recurrent PPV-related issues. However, long-term follow-up results are needed to evaluate the advantages and disadvantages in a larger case series.

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Ten year experience of laparoscopic repair of pediatric hydrocele and the long-term follow-up results

Cited by 15 publications

References 24 publications

Does the laparoscopic treatment of paediatric hydroceles represent a better alternative to the traditional open repair technique? A retrospective study of 1332 surgeries performed at two centres in China

Does the laparoscopic treatment of paediatric hydroceles represent a better alternative to the traditional open repair technique? A retrospective study of 1332 surgeries performed at two centres in China

Sclerotherapy of hydrocele with ethanol (a literature review)

Comparison of the Detection and Ligation of Patent Processus Vaginalis Between Laparoscopy-Assisted Transscrotal Orchiopexy and Single Scrotal Incision Orchiopexy

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