Advances in Surgical Sciences
Volume 2, Issue 1, February 2014, Pages: 1-4
Received: Jan. 7, 2014;
Published: Feb. 28, 2014
Views 3125 Downloads 240
Omid Amanollahi, Department of Pediatric surgery, Mohammad Kermanshahi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Diana Noemi Diaz, Madani Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
Vahid Moetamedi, Department of General Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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.
Diana Noemi Diaz,
New Technique for Herniotomy in Children-Clinical Trial, Advances in Surgical Sciences.
Vol. 2, No. 1,
2014, pp. 1-4.
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
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.
Ellis H., Heddle R. Does the peritoneum need to be closed at laparotomy? Br J Surg 1977.
F. R. Johnson, H. W. Whitting, Repair of parietal peritoneum, British Journal of Surgery pages 653–660, May 1962Volume 49, Issue 218,
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
Postlethwait RW. Recurrent inguinal hernia. Ann Surg 1985; 202: 777-779
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.
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.
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
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.
Smedberg.. SG, Broome AE, Gullmo A. Ligation of hernial sac? Surg. Clin. North Am. 1984
Gharaibeh KL., Matani YY., To ligate or not to ligate the hernial sac in adults? Saudi med j. 2000 Nov;21(11):1068-70.
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
CM, St Peter SD, Bakom A., Murphy PJ, Late abscess formation following indirect hernia repair utilizing silk suture. Pediatric surg. Int. 2007.