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Comparison of Inguinal Herniotomies with and Without Opening the External Oblique Aponeurosis in Children Above the Age of Two.

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Background Mitchell-Banks technique (MBT), in which inguinal canal is not opened, usually used in inguinal hernia repair in children under 2 years of age. The majority of pediatric surgeons tend… Click to show full abstract

Background Mitchell-Banks technique (MBT), in which inguinal canal is not opened, usually used in inguinal hernia repair in children under 2 years of age. The majority of pediatric surgeons tend to open the inguinal canal while performing inguinal hernia surgery in children over 2 years of age, called as modified Ferguson herniotomy (FH). Aims This study aimed to compare early and late complications of the MBT and FH in over 2 years of age patients who underwent inguinal hernia surgery. Patients and Methods We retrospectively reviewed the medical records of all children between 2 and 16 years old who underwent inguinal herniotomy procedure using the MBT and FH between January 2013 and December 2019. Patients were evaluated in terms of demographic data, early and late complications. Results This study included 834 children. Of these, 379 (44.8%) were operated on by an FH with opening the inguinal canal (Group 1), and 455 (55.2%) by MBT superficially to the external ring (Group 2). There were 68 (17.9%) females and 311 (82.1%) males in group 1, while there were 151 (33.2%) females and 304 (66.8%) males in group 2. Early complications were wound infection (1.1% in the group 1 vs. 1.3% in the group 2, P = 1.00) and scrotal hematoma (1.3% vs. 1.8%, P = 0.89). Late complications included recurrence (1.6% in the group 1 vs. 1.8% in the group 2, P = 0.12), undescended testis (2.1% vs. 0.7%, P = 0.71), testicular atrophy (1.5% vs. 0.4%, P = 0.79), and hydrocele (1.9% vs. 1.8%, P = 0.87). There was no statistically significant difference in terms of early and late complications ratio between two groups. Conclusion This study showed that inguinal hernia repair performed without opening the inguinal canal in children older than 2 years do not lead to an increase in complications. In this respect, MBT can be used as a simple and safe procedure in older children.

Keywords: inguinal hernia; late complications; without opening; inguinal canal; age; group

Journal Title: Nigerian journal of clinical practice
Year Published: 2022

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