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COMPARISON BETWEEN INGUINAL HERNIOTOMIES WITH AND WITHOUT INCISING EXTERNAL OBLIQUE APONEUROSIS: A RANDOMIZED
Shahnam Askarpour1, Mehran Peyvasteh1, Shaghayegh Sherafatmand1
1Ahvaz Jundishapur University of Medical Sciences, Department of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz, Khouzestan, Iran.
Insights
Pediatric inguinal herniotomy without incising the external oblique aponeurosis is a suitable alternative. This method showed no significant difference in recurrence or complications compared to the traditional approach, with fewer cases of hydrocele.
Area of Science:
- Pediatric Surgery
- Surgical Techniques
- Clinical Trials
Background:
- Inguinal herniotomy is a common surgical procedure in pediatric patients.
- Evaluating surgical techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare pediatric inguinal herniotomy with and without external oblique aponeurosis incision.
- To assess recurrence rates and complications between the two surgical methods.
Main Methods:
- A blinded clinical trial involving 800 pediatric patients with indirect inguinal hernia.
- Comparison of outcomes between herniotomy with and without external oblique aponeurosis incision.
- Evaluation of complications including hernia recurrence, nerve damage, hematoma, and testicular issues.
Main Results:
- No significant difference in hernia recurrence or most complications between the two groups.
- A significantly higher incidence of hydrocele was observed in the group with external oblique aponeurosis incision.
Conclusions:
- Herniotomy without incising the external oblique aponeurosis is a viable and potentially advantageous option.
- Pediatric patients may benefit from the less invasive approach, avoiding complications like hydrocele.
Background:
Inguinal herniotomy is the most common surgery performed by pediatric surgeons.
Aim:
To compare the results and complications between two conventional methods of pediatric inguinal herniotomy with and without incising external oblique aponeurosis in terms of recurrence of hernia and other complications.
Methods:
This one blinded clinical trial study was conducted on 800 patients with indirect inguinal hernia. Inclusion criterion was children with inguinal hernia. The first group underwent herniotomy without incising external oblique aponeurosis and second group herniotomy with incising external oblique aponeurosis. Recurrence of hernia and other complications including ileoinguinal nerve damage, hematoma, testicular atrophy, hydrocele, ischemic orchitis, and testicular ascent were evaluated.
Results:
Recurrence and other complications with or without incising external oblique aponeurosis had no significant difference, exception made to hydrocele significantly differed between the two groups, higher in the incision group.
Conclusion:
Herniotomy without incising oblique aponeurosis can be appropriate choice and better than herniotomy with incising oblique aponeurosis. Children with inguinal herniotomy can be benefit without incising oblique aponeurosis, instead of more interventional traditional method.
