WOFAPS 2025 8th World Congress of Pediatric Surgery

Fangfang Chen, Xiao You, Zheng Lu, ZhiDuan Xu, Yu Wang, SuHang Wang

The First Affiliated Hospital of Bengbu Medical University

Abstract

Purpose Appendicitis with inguinal hernia or concealed inguinal hernia found intraoperatively – how to deal with it? This study aimd to investigate the treatment methods of inguinal hernia during acute and chronic appendicitis surgery, and evaluate the efficacy and long-term prognosis of simultaneous appendectomy and inguinal hernia repair.

Methods A retrospective analysis was conducted on 16 pediatric patients who underwent simultaneous laparoscopic appendectomy and inguinal hernia repair at our treatment center between June 2018 and December 2024. The patients were categorized into two groups based on the pathological type of appendicitis: Group A (elective surgery for chronic appendicitis) and Group B (emergency surgery for other types, including acute appendicitis, suppurative appendicitis, and perforated gangrenous appendicitis). The study evaluated the clinical manifestations, surgical safety, treatment outcomes, and long-term prognosis of appendicitis with different pathological types.

Results During this period, our treatment center admitted a total of 510 cases of acute and chronic appendicitis undergoing laparoscopic appendectomy, including 16 pediatric cases (3.14%) with concomitant inguinal hernia, who underwent simultaneous laparoscopic appendectomy and inguinal herniorrhaphy. The surgical success rate was 100%. Postoperative pathological findings revealed 8 cases of chronic appendicitis in Group A, while Group B included 3 cases of acute simple appendicitis, 4 cases of acute suppurative appendicitis, and 1 case of perforated gangrenous appendicitis. Surgical duration, hospitalization time, and hospitalization costs were significantly higher in Group B compared to Group A, with statistical significance. There were no differences in postoperative complications such as incision infection, scrotal redness, or fluid accumulation between the two groups. Follow-up for six months showed no recurrence of inguinal hernia.

Conclusion Concerning children suffering from appendicitis with different levels of inflammation and various pathological types, concurrently presenting with inguinal hernia, simultaneous execution of laparoscopic appendectomy and high ligation of the hernial sac under laparoscopic guidance can preclude the need for a second anesthetic administration and surgical intervention. This approach proves to be safe, feasible, cost-effective, and economically prudent when accompanied by appropriate surgical management and postoperative care. As such, its selective clinical implementation is recommended.