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High ligation in adolescents: Is it enough?
Mark A Taylor1, Zachary A Cutshall2, R Scott Eldredge2
1University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA.
Journal of Pediatric Surgery
|November 25, 2020
Summary
High ligation for adolescent inguinal hernias is effective with a 6.0% recurrence rate. Cardiac and gastrointestinal comorbidities increase recurrence risk, requiring patient counseling.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- Adolescent inguinal hernia repair lacks a consensus standard, differing from adult mesh repair and pediatric high ligation.
- Investigating outcomes of high ligation in adolescents is crucial due to their unique developmental stage.
Purpose of the Study:
- To evaluate the effectiveness of high ligation for inguinal hernias in adolescents.
- To identify factors associated with an increased risk of hernia recurrence in this age group.
Main Methods:
- Retrospective cohort study of 256 adolescents (12-18 years) undergoing open high ligation for inguinal hernia (2000-2018).
- Comparison of demographic, medical history, and repair characteristics between recurrent and non-recurrent hernia cases.
Main Results:
- A 6.0% recurrence rate was observed, with a median reoperation time of 3.1 years.
- Recurrence was significantly associated with cardiac (25.0% vs. 5.8%) and gastrointestinal comorbidities (25% vs. 7.1%).
- No other significant differences were found between recurrent and non-recurrent cohorts.
Conclusions:
- High ligation is an effective treatment for adolescent inguinal hernias, offering an acceptable recurrence risk without mesh-related morbidity.
- Adolescents with cardiac or gastrointestinal comorbidities should be informed about their elevated risk of hernia recurrence.
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