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New Technique for Herniotomy in Children-Clinical Trial

Received: 7 January 2014     Published: 28 February 2014
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Abstract

Objective: to assessment of hernial sac ligation necessity after its transection in children herniotomy and 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 is a randomized controlled trial (RCT) Method: A total of 200 children ranging from neonates to 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran between march 2011 and march2012, for elective hernial surgery The patients who were more prone to recurrence; such as patients with incarcerated hernia and increased intra-abdominal pressure were excluded from the study. After exclusion of some patients, 182children included in the study. They were randomly allocated into 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. Conclusions: This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omitting ligation did not result in any significant effect on early and late complication.

Published in Advances in Surgical Sciences (Volume 2, Issue 1)
DOI 10.11648/j.ass.20140201.11
Page(s) 1-4
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Children, Herniotomy, Non Ligation, Hernial Sac, Recurrence

References
[1] Thomas R.Weber, Thomas F.Tracy jr, Marfin S. Keller,. Groin hernia and hydrocele in: Keith W. Ashcraft, George Whitfield Holcomb, J Patrick Murphy .Editors. Pediatric Surgery 4th edition 2005
[2] Eric w.Fonkalsrud md. Disorders of inguinal canal in:James A O’Neill,jr,, Jay l. Grosfeld , Eric W. Fonkalsrud, Arnold G. Coran, Anthony A. Caldamone, editors. Principles of Pediatric Surgery, second edition 2004 Missouri.mosby,inc. 1995: p.440.
[3] Ellis H., Heddle R. Does the peritoneum need to be closed at laparotomy? Br J Surg 1977.
[4] F. R. Johnson, H. W. Whitting, Repair of parietal peritoneum, British Journal of Surgery pages 653–660, May 1962Volume 49, Issue 218,
[5] Mohta A, Jain N,Iniraya KP, Saluja SS, Sharma S, Gupta A .Non ligation of the hernial sac during herniotomy: a prospective study. Pediatr surg int 2003
[6] Postlethwait RW. Recurrent inguinal hernia. Ann Surg 1985; 202: 777-779
[7] Shulman AG, Amid PK, Lichtenstein IL. Ligation of the hernia sac. A needless step in adult hernia. Pediatric surg int 2007; hernioplasty . Int surg 78:152-153.
[8] Aranda, Mario Riquelme-Q. Laparoscopic pediatric inguinal hernia repair: no ligation, just resection. Journal of Laparoendoscopic & Advanced Surgical Techniques. January/February 2010, 20(1): 77-80. doi:10.1089/lap.2008.0329.
[9] Veena Kumari, Nilay Biswas, Nilanjan Mitra, Hiralal Konar, Dipak Ghosh, and Sukanta K. J.is ligation of hernial sac during orchiopexy mandatory?. Indian Soc Pediatr Surg. 2009
[10] Delikoukos S., Lavant L., Hlias G., et al: the role of hernia sac ligation in postoperative pain in patients with elective tension-free indirect inguinal hernia repair:a prospective randomized study. Hernia. 2007.
[11] Smedberg.. SG, Broome AE, Gullmo A. Ligation of hernial sac? Surg. Clin. North Am. 1984
[12] Gharaibeh KL., Matani YY., To ligate or not to ligate the hernial sac in adults? Saudi med j. 2000 Nov;21(11):1068-70.
[13] Imamuglu M., Cay A., Sarihan H., Ahmetoglu A., Ozdemir O. Paravesical abscess as an unusual late complication of inguinal hernia repair in children. Pediatric Surgery International - volume23, number 4, 349-352
[14] CM, St Peter SD, Bakom A., Murphy PJ, Late abscess formation following indirect hernia repair utilizing silk suture. Pediatric surg. Int. 2007.
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    Omid Amanollahi, Diana Noemi Diaz, Vahid Moetamedi. (2014). New Technique for Herniotomy in Children-Clinical Trial. Advances in Surgical Sciences, 2(1), 1-4. https://doi.org/10.11648/j.ass.20140201.11

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    ACS Style

    Omid Amanollahi; Diana Noemi Diaz; Vahid Moetamedi. New Technique for Herniotomy in Children-Clinical Trial. Adv. Surg. Sci. 2014, 2(1), 1-4. doi: 10.11648/j.ass.20140201.11

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    AMA Style

    Omid Amanollahi, Diana Noemi Diaz, Vahid Moetamedi. New Technique for Herniotomy in Children-Clinical Trial. Adv Surg Sci. 2014;2(1):1-4. doi: 10.11648/j.ass.20140201.11

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  • @article{10.11648/j.ass.20140201.11,
      author = {Omid Amanollahi and Diana Noemi Diaz and Vahid Moetamedi},
      title = {New Technique for Herniotomy in Children-Clinical Trial},
      journal = {Advances in Surgical Sciences},
      volume = {2},
      number = {1},
      pages = {1-4},
      doi = {10.11648/j.ass.20140201.11},
      url = {https://doi.org/10.11648/j.ass.20140201.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20140201.11},
      abstract = {Objective: to assessment of hernial sac ligation necessity after its transection in children herniotomy and 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 is a randomized controlled trial (RCT) Method: A total of 200 children ranging from neonates to 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran between march 2011 and march2012, for elective hernial surgery The patients who were more prone to recurrence; such as patients with incarcerated hernia and increased intra-abdominal pressure were excluded from the study. After exclusion of some patients, 182children included in the study. They were randomly allocated into 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. Conclusions: This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omitting ligation did not result in any significant effect on early and late complication.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - New Technique for Herniotomy in Children-Clinical Trial
    AU  - Omid Amanollahi
    AU  - Diana Noemi Diaz
    AU  - Vahid Moetamedi
    Y1  - 2014/02/28
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ass.20140201.11
    DO  - 10.11648/j.ass.20140201.11
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 1
    EP  - 4
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20140201.11
    AB  - Objective: to assessment of hernial sac ligation necessity after its transection in children herniotomy and 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 is a randomized controlled trial (RCT) Method: A total of 200 children ranging from neonates to 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran between march 2011 and march2012, for elective hernial surgery The patients who were more prone to recurrence; such as patients with incarcerated hernia and increased intra-abdominal pressure were excluded from the study. After exclusion of some patients, 182children included in the study. They were randomly allocated into 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. Conclusions: This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omitting ligation did not result in any significant effect on early and late complication.
    VL  - 2
    IS  - 1
    ER  - 

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Author Information
  • Department of Pediatric surgery, Mohammad Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

  • Madani Hospital, Zanjan University of Medical Sciences, Zanjan, Iran

  • Department of General Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

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