Abstract:
Background: Encysted hydrocele of the canal of Nuck (EHCN) is homologous to spermatic cord hydrocele in males. EHCN causes swelling in the inguinal region and should be considered in the differential diagnosis of inguinal hernias and masses in females. Complete excision and internal inguinal ring closure are the recommended treatments for symptomatic EHCN. In this study, we aimed at evaluating the safety and feasibility of laparoscopic hydrocelectomy, as well as age-appropriate procedures for EHCN. Materials and Methods: The medical records of 161 female adults and children, who underwent laparoscopic transabdominal hydrocelectomy from January 2014 to December 2020 at a single institution, were reviewed retrospectively and symptoms, location of EHCN, type of fluid in EHCN, postoperative complications, recurrence, and operating time were analyzed. Laparoscopic hydrocelectomy was performed and the internal inguinal ring was closed with high ligation in children and iliopubic tract repair (IPTR) in adults. Results: Fifty-two pediatric (age 2-11 years) and 109 adult (age 21-51 years) female patients were included. More adult patients had inguinal pain (34.9%, 38/109) compared with children (3.8% 2/52) (P < .001). More EHCNs were located in the inguinal canal than protruding into the abdominal cavity in both groups. Regarding the fluid characteristics, hemorrhagic and inflammatory hydroceles were more common in adults than in children (P < .001). There were no serious complications, neither recurrence nor chronic pain was observed in either group except for a surgical-site hematoma in 1 adult patient. Conclusion: Laparoscopic hydrocelectomy together with additional age-appropriate procedures, including high ligation in children and IPTR in adults, is a safe and feasible method for treating EHCN.
摘要:
背景:Nuck管囊鞘膜积液(EHCN)与男性精索鞘膜积液同源。EHCN会导致腹股沟区肿胀,应在女性腹股沟疝和肿块的鉴别诊断中考虑。完全切除和腹股沟内环闭合是有症状的EHCN的推荐治疗方法。在这项研究中,我们的目的是评估腹腔镜子宫内膜切除术的安全性和可行性,以及EHCN的适合年龄的程序。材料和方法:161名女性成人和儿童的病历,从2014年1月至2020年12月在单一机构接受腹腔镜经腹子宫积液切除术,回顾性回顾和症状,EHCN的位置,EHCN中的流体类型,术后并发症,复发,并对手术时间进行了分析。进行了腹腔镜下膀胱切除术,并在儿童中进行了高位结扎术,在成人中进行了腹股沟内环的闭合。结果:52名儿童(2-11岁)和109名成人(21-51岁)女性患者被纳入。更多的成人患者有腹股沟疼痛(34.9%,38/109)与儿童(3.8%2/52)相比(P<.001)。在两组中,位于腹股沟管中的EHCN多于伸入腹腔的EHCN。关于流体特性,出血性和炎性鞘膜积液在成人中比在儿童中更常见(P<.001).没有出现严重的并发症,除1例成年患者的手术部位血肿外,两组均未观察到复发或慢性疼痛.结论:腹腔镜子宫内膜切除术以及其他适合年龄的手术,包括儿童高位结扎术和成人IPTR,是一种安全可行的治疗EHCN的方法。