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This study on childhood inguinal hernias found that operating only on symptomatic sides reduces unnecessary surgeries. This approach minimizes risks associated with bilateral exploration and herniorrhaphy in pediatric patients.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Context:
- Inguinal hernias are common in childhood, accounting for 28% of pediatric operations between 1967-1985.
- The study analyzed 611 cases of childhood inguinal hernias operated on during this period.
Purpose:
- To evaluate the surgical management of childhood inguinal hernias.
- To assess the efficacy and necessity of bilateral exploration and herniorrhaphy in pediatric patients.
Summary:
- The study reviewed 611 pediatric inguinal hernia cases, noting a mean age of 33 months and a male-to-female ratio of 5.43:1.
- The right side was most affected (64.64%), with 14.89% bilaterality. Incarceration occurred in 13.23% of cases, requiring urgent surgery in 35.63%.
- Relapse rates were low (0.45%), and contralateral metacronous hernias occurred in 7.99% of cases.
Impact:
- The findings suggest that operating only on symptomatic inguinal hernias in children, without routine bilateral exploration, can prevent unnecessary and potentially harmful procedures.
- This conservative approach may lead to better outcomes and reduced healthcare costs in pediatric hernia repair.
Abstract:
The authors report 611 cases of inguinal hernias of childhood operated between 1967 and 1985, which represent 28% of operations performed in all children in the same period. The mean age of patients was 33 +/- 4.1 months and the ratio M:F = 5.43:1. The right side was the most frequently affected (64.64%) with a bilaterality of 14.89%. The incarceration, observed at the rate of 13.23%, needed the surgical treatment in urgency in the 35.63% of the cases. A relapsing hernia appeared only two times (0.45%) and the incidence of contralateral metacronous hernias was 7.99%. They perform herniorrhaphy in the only symptomatic side without preoperative herniorrhaphy and operate on the silent contralateral side only when there a hernia will became symptomatic, as they think that herniorrhaphy and bilateral inguinal exploration cause a high number of unnecessary, sometimes harmful operations.