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Article: Management of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplasty

TitleManagement of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplasty
Authors
KeywordsCord lipoma
Inguinal hernia
Laparoscopy
Recurrence
Issue Date2007
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2007, v. 21 n. 9, p. 1612-1616 How to Cite?
AbstractBackground: Herniation of retroperitoneal adipose tissue into the inguinal canal, traditionally called cord lipoma, is frequently encountered during endoscopic totally extraperitoneal inguinal hernioplasty (TEP). Failure to recognize and manage the cord lipoma accounted for 30%-50% of recurrent hernia after TEP. The present study was undertaken to evaluate the incidence, risk factors, and management of herniated retroperitoneal adipose tissue during TEP. Methods: Between December 2002 and November 2005 all patients who underwent TEP were prospectively evaluated for the presence of cord lipoma. Clinical outcomes of patients who were treated for their cord lipoma were compared with those without cord lipoma. Risk factors for the occurrence of cord lipoma were also examined. Results: A total of 498 patients underwent unilateral (n = 386) or bilateral (n = 112) TEP. The overall incidence of cord lipoma was 26.5% (n = 132). A higher body weight, a higher body mass index, and a larger hernial defect were significantly associated with the presence of cord lipoma. Most of the cord lipoma cases (n = 119) were reduced to pelvic peritoneal reflection line after division of the feeding vessels from surrounding structures, while the rest (n = 13) were resected. Early postoperative outcomes, including pain score, morbidities, and other recovery variables, showed no significant difference between the two groups. No recurrence occurred in the present series. Conclusions: Herniation of retroperitoneal adipose tissue into the inguinal canal occurred in more than one-fifth of the patients with inguinal hernia. Awareness and appropriate treatment of the cord lipoma helped to reduce the risk of recurrence. During TEP, the internal inguinal ring and inguinal canal should always be cleared of any herniated adipose tissue by either reduction or resection. This clearing posed no adverse effects on postoperative outcome. © 2007 Springer Science+Business Media, LLC.
Persistent Identifierhttp://hdl.handle.net/10722/84240
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLau, Hen_HK
dc.contributor.authorLoong, Fen_HK
dc.contributor.authorYuen, WKen_HK
dc.contributor.authorPatil, NGen_HK
dc.date.accessioned2010-09-06T08:50:37Z-
dc.date.available2010-09-06T08:50:37Z-
dc.date.issued2007en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2007, v. 21 n. 9, p. 1612-1616en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84240-
dc.description.abstractBackground: Herniation of retroperitoneal adipose tissue into the inguinal canal, traditionally called cord lipoma, is frequently encountered during endoscopic totally extraperitoneal inguinal hernioplasty (TEP). Failure to recognize and manage the cord lipoma accounted for 30%-50% of recurrent hernia after TEP. The present study was undertaken to evaluate the incidence, risk factors, and management of herniated retroperitoneal adipose tissue during TEP. Methods: Between December 2002 and November 2005 all patients who underwent TEP were prospectively evaluated for the presence of cord lipoma. Clinical outcomes of patients who were treated for their cord lipoma were compared with those without cord lipoma. Risk factors for the occurrence of cord lipoma were also examined. Results: A total of 498 patients underwent unilateral (n = 386) or bilateral (n = 112) TEP. The overall incidence of cord lipoma was 26.5% (n = 132). A higher body weight, a higher body mass index, and a larger hernial defect were significantly associated with the presence of cord lipoma. Most of the cord lipoma cases (n = 119) were reduced to pelvic peritoneal reflection line after division of the feeding vessels from surrounding structures, while the rest (n = 13) were resected. Early postoperative outcomes, including pain score, morbidities, and other recovery variables, showed no significant difference between the two groups. No recurrence occurred in the present series. Conclusions: Herniation of retroperitoneal adipose tissue into the inguinal canal occurred in more than one-fifth of the patients with inguinal hernia. Awareness and appropriate treatment of the cord lipoma helped to reduce the risk of recurrence. During TEP, the internal inguinal ring and inguinal canal should always be cleared of any herniated adipose tissue by either reduction or resection. This clearing posed no adverse effects on postoperative outcome. © 2007 Springer Science+Business Media, LLC.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectCord lipomaen_HK
dc.subjectInguinal herniaen_HK
dc.subjectLaparoscopyen_HK
dc.subjectRecurrenceen_HK
dc.titleManagement of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplastyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=21&issue=9&spage=1612&epage=1616&date=2007&atitle=Management+of+herniated+retroperitoneal+adipose+tissue+during+endoscopic+extraperitoneal+inguinal+hernioplastyen_HK
dc.identifier.emailPatil, NG: ngpatil@hkucc.hku.hken_HK
dc.identifier.authorityPatil, NG=rp00388en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-007-9205-0en_HK
dc.identifier.pmid17762958-
dc.identifier.scopuseid_2-s2.0-34548433036en_HK
dc.identifier.hkuros135915en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34548433036&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1612en_HK
dc.identifier.epage1616en_HK
dc.identifier.isiWOS:000249555400027-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLau, H=7201497812en_HK
dc.identifier.scopusauthoridLoong, F=6602794154en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK
dc.identifier.scopusauthoridPatil, NG=7103152514en_HK
dc.identifier.citeulike2058367-

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