Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2025; 17(1): 99155
Published online Jan 27, 2025. doi: 10.4240/wjgs.v17.i1.99155
Effect of ligamentum teres uteri preservation in laparoscopic high hernia sac ligation in children with indirect inguinal hernia
Xiao-Qiang Lin, Hua-Fang Li, Yan-Zhu Lin, Wen-You Chen
Xiao-Qiang Lin, Hua-Fang Li, Yan-Zhu Lin, Wen-You Chen, Department of Pediatric Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
Co-first authors: Xiao-Qiang Lin and Hua-Fang Li.
Co-corresponding authors: Yan-Zhu Lin and Wen-You Chen.
Author contributions: Lin XQ, Li HF, Lin YZ and Chen WY designed the research; Lin XQ and Li HF screened patients, acquired clinical data; Lin XQ, Li HF, Lin YZ and Chen WY conducted the analysis and provided guidance for the research; Lin XQ, Li HF, Lin YZ and Chen WY performed data analysis and prepared the first draft of the manuscript. Lin XQ and Li HF proposed, designed the research, performed data analysis and prepared the first draft of the manuscript. Lin XQ and Li HF were responsible for patient screening, enrollment, collection of clinical data. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. All authors reviewed and approved the final manuscript. Lin XQ and Li HF contributed equally to this work and are co-first authors. Both Lin YZ and Chen WY have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Lin XQ applied for and obtained the funds for this research project. Lin YZ conceptualized, designed, and supervised the whole process of the project. Chen WY searched the literature, revised and submitted the early version of the manuscript. Lin XQ and Li HF were instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Lin XQ and Li HF is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by the Startup Fund for Scientific Research, Fujian Medical University, No. 2021QH1262.
Institutional review board statement: This study was approved by the Ethic Committee of Zhangzhou Affiliated Hospital of Fujian Medical University, No.2024KY230.
Informed consent statement: This was a retrospective study, and the requirement for informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data used in this study are available from the corresponding author chenwy0596@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-You Chen, MD, Associate Chief Physician, Department of Pediatric Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, No. 193 Shuixian Street, Longwen District, Zhangzhou 363000, Fujian Province, China. chenwy0596@163.com
Received: September 12, 2024
Revised: October 18, 2024
Accepted: November 12, 2024
Published online: January 27, 2025
Processing time: 106 Days and 5.1 Hours
Abstract
BACKGROUND

Routinely separating the ligamentum teres uteri (LTU) intraoperatively remains an unresolved issue for female children undergoing surgery for indirect inguinal hernia (IIH).

AIM

To identify the effect of LTU preservation in laparoscopic high hernia sac ligation (LHSL) in children with IIH.

METHODS

The participants were 100 female children with unilateral IIH admitted from April 2022 to January 2024 to the Pediatric Surgery Department of Zhangzhou Municipal Hospital of Fujian Province. They were categorized based on LTU retention into the control group (n = 45 cases), which underwent LTU ligation intraoperatively, and the experimental group (55 cases), which had the LTU preserved intraoperatively. All children underwent LHSL.

RESULTS

This study comparatively analyzed the operation time, hospitalization time, blood loss, postoperative recurrence rate, and complications (repeated pain in the inguinal region, foreign body sensation in the inguinal region, bloody exudation at the inguinal incision, and incision infection), which were all comparable between the two groups.

CONCLUSION

The above results indicate that LTU preservation during LHSL exerts certain therapeutic benefits for children with IIH. LTU preservation does not increase hospitalization time, blood loss, postoperative recurrence rate, and complications, which is safe and feasible, compared with conventional LTU ligation. LHSL with LTU preservation should be performed if conditions permit, which is worth popularizing.

Keywords: Indirect inguinal hernia; Laparoscopic high hernia sac ligation; Ligamentum teres uteri; Therapeutic effect; Pediatric surgery

Core Tip: The ligamentum teres uteri (LTU) is one of the main ligaments of the uterus and plays a crucial role in maintaining the anteverted uterine position. However, currently, the surgical method of ligating the LTU together with the hernia sac is mostly adopted intraoperatively for female patients with indirect inguinal hernia, which may cause LTU ligation-associated complications in some female children. This study revealed that LTU preservation intraoperatively does not increase hospital stay, blood loss, postoperative recurrence rate, or complications, which is safe and feasible, compared with conventional LTU ligation. Laparoscopic high hernial sac ligation with LTU preservation should be performed when conditions permit, which is worthy of popularization.