Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil.
Hernia. 2024 Aug;28(4):1451-1455. doi: 10.1007/s10029-024-03080-2. Epub 2024 Jun 5.
Cord lipomas are frequent findings in laparoscopic inguinal hernia surgeries in male patients. The symptoms of lipoma and the potential benefits of removing them are often overlooked because the focus is on the primary pathology of the hernia itself. Current recommendations are to reduce this fatty content, when present. When inguinal cord lipomas are left untreated in inguinal hernia surgery they can potentially cause symptoms and be detected in follow-up imaging exams. The objective of this study was to study incidence of cord lipomas in a cohort operated on by a single group specializing in abdominal wall surgery, as well as to analyze the possible relationship of this finding with the patient's symptoms, the characteristics of the operated hernia and postoperative outcome. This is a prospective study of male patients operated on for inguinal hernia laparoscopically or robotically in a single reference center. Of the total of 141 hernias, the distribution according to European Hernia Society classification showed that 45.4% were lateral, 19.1% medial and 35.5% mixed, highlighting a variety in the presentation of hernias. Analysis of the size of the hernias revealed that the majority (35.5%) were ≤ 1.5 cm. Inguinal cord lipoma was present in 64.5% of the samples, with no statistically significant association between the presence of the lipoma and an indirect hernia sac or obesity. The incidence of surgical site occurrences (SSO) was 9,2%, with seroma and hematoma. No recurrences were observed during follow-up, indicating a successful approach. There were no statistically significant relationships between SSO, the presence of lipoma and indirect hernial sac.
在男性腹腔镜腹股沟疝手术中，精索脂肪瘤是常见的发现。由于手术的重点是疝本身的主要病变，因此脂肪瘤的症状和切除它们的潜在益处常常被忽视。目前的建议是减少这种脂肪含量（如果存在的话）。在腹股沟疝手术中，如果不治疗腹股沟精索脂肪瘤，它们可能会引起症状，并在后续的影像学检查中被发现。本研究的目的是研究由专门从事腹壁手术的单一团队对一组患者进行手术时精索脂肪瘤的发生率，并分析该发现与患者症状、手术疝的特征和术后结果之间的可能关系。这是一项对在单一参考中心接受腹腔镜或机器人腹股沟疝手术的男性患者进行的前瞻性研究。在总共 141 例疝中，根据欧洲疝学会分类的分布显示，外侧疝占 45.4%，内侧疝占 19.1%，混合疝占 35.5%，突出了疝的多样性表现。对疝大小的分析表明，大多数（35.5%）疝的直径≤1.5cm。精索脂肪瘤存在于 64.5%的样本中，但脂肪瘤的存在与间接疝囊或肥胖之间没有统计学上的显著关联。手术部位发生（SSO）的发生率为 9.2%，包括血清肿和血肿。在随访期间没有观察到复发，表明手术方法是成功的。SSO、脂肪瘤的存在与间接疝囊之间没有统计学上的显著关系。
