%0 Journal Article
%T Resection versus Preservation of Spermatic Cord Lipoma Present with Inguinal Hernia during Laparoscopic TAPP Repair; a Comparative Study
%J The Egyptian Journal Of Hospital Medicine
%I Pan Arab League of Continuous Medical Education
%X <strong>Background:</strong> Spermatic cord lipoma (SCL) is a common incidental finding during inguinal hernia repair. The optimal management, excision versus preservation, remains debated, with proponents of each approach citing distinct benefits regarding postoperative complications and recurrence rates. <strong>Objective:</strong> This study aimed to compare the postoperative outcomes of spermatic cord lipoma excision versus lipoma preservation in patients undergoing laparoscopic TAPP inguinal hernia repair.
<strong>Patients and methods:</strong> A prospective comparative study of 100 male patients divided into two groups (50 per group) who underwent laparoscopic TAPP inguinal hernia repair. Group A where patients underwent concurrent spermatic cord lipoma excision and group B where patients had their lipoma preserved. Demographic variables, hernia type, and postoperative outcomes including scrotal swelling, pain, hematoma, false recurrence, true recurrence, and reoperation were recorded.
<strong>Results: </strong>The mean age was 41.82 ¡À 11.27 years in group A and 47.98 ¡À 14.28 years in group B (p = 0.019). Indirect inguinal hernia was the most prevalent type in both groups. Group A exhibited a significantly higher incidence of scrotal swelling (12% vs. 2%, p = 0.050) and lower postoperative pain (4% vs. 16%, p = 0.046). Elevated BMI was significantly associated with scrotal swelling, hematoma, and false recurrence in group A. In group B, false recurrence was significantly associated with direct and bilateral hernia types (p = 0.018). True recurrence and reoperation rates were low and comparable between groups (2% each overall). BMI correlated positively with age in group B (r = 0.363, p = 0.010). <strong>Conclusion:</strong> Spermatic cord lipoma excision was associated with higher rates of scrotal swelling but lower postoperative pain compared to preservation. Both approaches demonstrated low recurrence and reoperation rates. Individualized decision-making based on hernia type, patient BMI, and clinical context is recommended. Further prospective randomized trials are warranted.
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%K Spermatic cord lipoma
%K Inguinal hernia
%K laparoscopic TAPP repair
%U https://ejhm.journals.ekb.eg/article_506811_90ef5e70ada2b49a0fe6231dc4b59c4b.pdf