简介:精索脂肪瘤在所有腹股沟疝修补术的20-70%中发现。在这些病例中,腹股沟疝有膨出和疼痛但没有实际的间接疝囊的临床表现可能会出现在多达8%的病例中。漏诊精索脂肪瘤可导致复发或假性复发。这篇综述介绍了关于这一主题的相关文献。材料与方法:2020年2月,使用Medline对现有文献进行了系统搜索,PubMed,谷歌学者,Scopus,Embase,SpringerLink,还有Cochrane图书馆,以及搜索相关期刊和参考列表。确定了与该主题相关的42种出版物。结果:精索脂肪瘤似乎起源于内精索筋膜内的腹膜前脂肪组织,在地形上靠近动脉,静脉,淋巴管,神经,和精索内的不同导管。临床上无法做出可靠的诊断,而是用超声波,CT,或MRI。在没有真正的疝气囊的情况下,根据欧洲疝学会(EHSLI),精索脂肪瘤被归类为腹股沟外侧疝,缺损大小<1.5cm.漏诊或治疗不当的精索脂肪瘤会导致复发或假性复发。由于精索脂肪瘤从腹膜前间隙获得血管供应,它可以减少或切除。结论:精索脂肪瘤是腹股沟疝修补术中的常见病,必须根据精索的解剖结构进行正确的诊断和治疗。
Introduction: A spermatic cord lipoma is found in 20-70% of all inguinal hernia repairs. The clinical picture of an inguinal hernia with bulging and pain but without an actual indirect hernia sac may become manifest in up to 8% of these cases. Missed spermatic cord lipoma can result in recurrence or pseudo-recurrence. This review presents the relevant literature on this topic. Materials and Methods: A systematic search of the available literature was performed in February 2020 using Medline, PubMed, Google Scholar, Scopus, Embase, Springer Link, and the Cochrane Library, as well as a search of relevant journals and reference lists. Forty-two publications were identified as relevant for this topic. Results: Spermatic cord lipoma seems to originate from preperitoneal fatty tissue within the internal spermatic fascia in topographical proximity to the arteries, veins, lymphatics, nerves, and deferent duct within the spermatic cord. Reliable diagnosis cannot be made clinically, but rather with ultrasound, CT, or MRI. In the absence of a real hernia sac, a spermatic cord lipoma is classified as a lateral inguinal hernia with a defect size <1.5 cm according to the European Hernia Society (EHS LI). Missed or inadequately treated spermatic cord lipoma results in recurrence or pseudo-recurrence. Since spermatic cord lipoma obtains its vascular supply from the preperitoneal space, it can be reduced or resected. Conclusion: Spermatic cord lipoma is a common finding in inguinal hernia repairs and must be properly diagnosed and treated with care respecting the anatomy of the spermatic cord.