The necessity of routine histologic examination of hernia sac, revisited.

ABSTRACT

PURPOSE: To validate the need of continuing the current practice of histologic examination of hernia sacs (HS). METHODS: All HS received by our laboratory over 15 years were reviewed for any pathological findings. Cases harboring these results were selectively re-examined histologically by a pathologist and their charts were reviewed by a surgeon checking for clinical significance. Moreover, previous studies were analyzed to reach a final conclusion. RESULTS: Pathological findings were noted in only 13.7 and 12.8% of adults and kids HS, respectively. None of these had significant impact on patient care. CONCLUSIONS: Serious pathologies reported in HS in the literature are rare. This, coupled with our data, suggest that the current practice of routine microscopic examination of HS is not justified. Criteria are proposed for categorizing cases as eligible for histologic evaluation. This will significantly reduce the workload and contain the cost.