New technique for herniotomy in children: A clinical trial

Abstract

Objective This study aimed to assess the necessity of hernial sac ligation after its  transection in herniotomy in children and to compare the recurrence and  complication rates between two methods of hernial repair in children (the classic method with ligation of the hernial sac and a new method without sac ligation). Study design This was a randomized-controlled trial (or a randomized comparative trial).
Materials and methods A total of 200 children, newborns to children 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran, between March 2011 and 2012 for elective hernial surgery. Patients who were more susceptible to recurrence such as patients with incarcerated hernia and increased intraabdominal pressure were excluded from the study. After exclusion of a few patients, 182 children were included in the study. They were allocated randomly to two groups: a study group (herniotomy without sac ligation) and a control group (herniotomy with sac ligation). Both groups were followed up for a period of 1–1.5 years postoperatively for recurrence or other complications.
Results There was only one case of recurrent hernia in the control group and none in the study group. There was no statistically significant difference in the rate of recurrence or other complications between the two groups.
Conclusion This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omission of ligation did not result in any significant effect on early and late complications.

Keywords: children, hernial sac, herniotomy, non ligation, recurrence