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Open inguinal herniotomy: Analysis of variations

BACKGROUND: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of op...

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Autores principales: Ibrahim, Musa, Ladan, Mu’azu Adamu, Abdussalam, Umar Sharif, Getso, Kabiru Ibrahim, Mohammad, Mohammad Aminu, Chukwuemeka, Anyanwu Lofty-John, Owolabi, Femi Luqman, Akhparov, Nurlan Nurkenovich, Aipov, Rassulbek Rakhmanberdievich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955417/
https://www.ncbi.nlm.nih.gov/pubmed/26168752
http://dx.doi.org/10.4103/0189-6725.160361
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author Ibrahim, Musa
Ladan, Mu’azu Adamu
Abdussalam, Umar Sharif
Getso, Kabiru Ibrahim
Mohammad, Mohammad Aminu
Chukwuemeka, Anyanwu Lofty-John
Owolabi, Femi Luqman
Akhparov, Nurlan Nurkenovich
Aipov, Rassulbek Rakhmanberdievich
author_facet Ibrahim, Musa
Ladan, Mu’azu Adamu
Abdussalam, Umar Sharif
Getso, Kabiru Ibrahim
Mohammad, Mohammad Aminu
Chukwuemeka, Anyanwu Lofty-John
Owolabi, Femi Luqman
Akhparov, Nurlan Nurkenovich
Aipov, Rassulbek Rakhmanberdievich
author_sort Ibrahim, Musa
collection PubMed
description BACKGROUND: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. MATERIALS AND METHODS: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). RESULTS: A total of 458 repairs were done. Patients’ age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 ± 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 ± 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 ± 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 ± 4.19 (median, 4). Operation time per repair was 26.50 ± 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 ± 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 ± 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 ± 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 ± 1.43, 2.94 ± 0.81, 2.18 ± 0.69, 1.87 ± 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. CONCLUSION: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers no advantage.
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spelling pubmed-49554172016-09-01 Open inguinal herniotomy: Analysis of variations Ibrahim, Musa Ladan, Mu’azu Adamu Abdussalam, Umar Sharif Getso, Kabiru Ibrahim Mohammad, Mohammad Aminu Chukwuemeka, Anyanwu Lofty-John Owolabi, Femi Luqman Akhparov, Nurlan Nurkenovich Aipov, Rassulbek Rakhmanberdievich Afr J Paediatr Surg Original Article BACKGROUND: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. MATERIALS AND METHODS: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). RESULTS: A total of 458 repairs were done. Patients’ age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 ± 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 ± 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 ± 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 ± 4.19 (median, 4). Operation time per repair was 26.50 ± 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 ± 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 ± 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 ± 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 ± 1.43, 2.94 ± 0.81, 2.18 ± 0.69, 1.87 ± 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. CONCLUSION: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers no advantage. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4955417/ /pubmed/26168752 http://dx.doi.org/10.4103/0189-6725.160361 Text en Copyright: © 2015 African Journal of Paediatric Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Ibrahim, Musa
Ladan, Mu’azu Adamu
Abdussalam, Umar Sharif
Getso, Kabiru Ibrahim
Mohammad, Mohammad Aminu
Chukwuemeka, Anyanwu Lofty-John
Owolabi, Femi Luqman
Akhparov, Nurlan Nurkenovich
Aipov, Rassulbek Rakhmanberdievich
Open inguinal herniotomy: Analysis of variations
title Open inguinal herniotomy: Analysis of variations
title_full Open inguinal herniotomy: Analysis of variations
title_fullStr Open inguinal herniotomy: Analysis of variations
title_full_unstemmed Open inguinal herniotomy: Analysis of variations
title_short Open inguinal herniotomy: Analysis of variations
title_sort open inguinal herniotomy: analysis of variations
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955417/
https://www.ncbi.nlm.nih.gov/pubmed/26168752
http://dx.doi.org/10.4103/0189-6725.160361
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