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.
Highlights
Hydrocele in children is one of the common congenital diseases in boys [1, 2]
In the Laparoscopic repair (LR) group, laparoscopic percutaneous extraperitoneal closure (LPEC) was performed extraperitoneally with an abdominal wall suture device with a water injection function (Figure 1), which was produced by Xiamen Surgaid Medical Equipment Co., Ltd., of China (Patent No.: ZL 201620804971.6)
A spring is installed in the sheath of the hand-held part of the back end, which is convenient for the operator to pull out the needle core and hook the ligation line at Abbreviations: patent processus vaginalis (PPV), Patent processus vaginalis; open repair (OR), Open repair; LR, Laparoscopic repair; LPEC, laparoscopic percutaneous extraperitioneal closure
Summary
Hydrocele in children is one of the common congenital diseases in boys [1, 2]. The main reason for this is that intraperitoneal fluid enters the scrotum through a congenital patent processus vaginalis (PPV), forming hydrocele [3, 4]. Children with a communicating hydrocele are different from adults, and simple high ligation of the PPV can achieve satisfactory results [3, 5]. Traditional open repair (OR) surgery has the characteristics of a simple operation and strong popularity and it is accepted by the majority of pediatric surgeons. Some scholars believe that OR leads to considerable postoperative pain, can cause damage to the spermatic cord blood vessels and vas deferens, leaves a visible postoperative incision, and has other problems [6, 7].
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