Management of postoperative recurrence of inguinal hernia in adolescents: An analysis of 9 cases / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To analyze the reoperation method and effect of recurrent inguinal hernia in adolescents after operation. METHODS: The data of 9 adolescent(13 to 18 years old) inguinal hernia patients with recurrence after surgical treatment admitted in the first people's hospital of Foshan from January 2006 to December 2018 were analyzed retrospectively. The methods of previous operation, reoperation, size of internal ring, major postoperative complications and recurrence rate were collected. RESULTS: Among the 170 adolescent patients who underwent inguinal hernia surgery,there were 9 cases of recurrent indirect inguinal hernia(the previous operation method was high ligation of the internal ring), including 2 cases of open surgery and 7 cases of laparoscopic surgery. Of the 9 patients, 3 had multiple recurrences and 6 had first recurrence. The sizes of internal ring were 0.3 to 3.0 cm in the operation. Surgical methods: 4 cases were performed with laparoscopic high ligation of internal ring, with the sizes of internal ring ranging from 0.3 cm to 2.0 cm. Laparoscopic inguinal hernia mesh repair was performed in 5 patients(3 patients with multiple recurrences)with the sizes of internal ring ranging from 1.5 cm to 3.0 cm. During the follow-up period of 6 months to 10 years, no wound or mesh infection, 3 patients showed discomfort in the inguinal area, 2 patients had mesh repair and 1 patient had high ligation. Seroma appeared in 1 patient which was repaired by mesh. One case of recurrence which was mesh repair.CONCLUSION: The choice of surgical method for recurrent inguinal hernia in adolescents should be based on the previous surgical method, recurrence frequency and the presence of large internal ring defect or transverse abdominal fascia defect. Laparoscopic high ligation is recommended for patients with primary recurrence of small internal ring defect. For patients with multiple recurrence or large internal ring defect, mesh repair is recommended.