Herniotomy in resource-scarce environment: Comparison of incisions and techniques.

Abstract

BACKGROUND:

There are various methods for surgical treatment of hernia and hydrocele in children with variable cost-effectiveness, recovery and cosmetic outcomes. This study analyses our experience with mini-incision/invasive herniotomy in children in resource-limited centre.

MATERIALS AND METHODS:

Seven hundred and eighty-four n = 784 patients underwent herniotomy via conventional and mini-invasive methods were assigned into Group A and Group B. Three hundred and seventy-six n = 376 (47.95%) in Group A while four hundred and eight n = 408 (52.04%) in Group B. Eight hundred and seventeen (817) herniotomy was performed. Demographic data, hernia/hydrocele sides, volume of surgical suture used, surgery duration, and complications analysed.

RESULTS:

Right side hernia and/or hydrocele were 464 (59.18%). 287 (36.60%) had left sided while 33 (4.21%) had bilateral hernia and/or hydrocele. There were 14 bilateral hernia repair in Group A and 19 in Group B. The lengths of operation time for unilateral repair ranged from 14 to 54 min in Group A (median, 23 min) and 7-44 min in Group B (median, 15 min) with a mean surgical duration of 15.48 ± 4.16 min in Group B versus 23.41 ± 5.94 min in Group A (P < 0.001) while the range of the lengths of operation time for bilateral repair in Group A was 20-54 min (median, 36) and 12-30 min (median, 21) in Group B with a mean duration of 36.35 ± 9.89 min in Group A versus 20.42 ± 4.83 min in Group B P = 0.00563. 376 sachets of 45 cm suture material were used in Group A versus 137 in Group B. There were total of 87 (23.13%) complications in Group A versus 3 (1.47%) in Group B P = 0.000513. Superficial wound infection and abscess were 9 (2.36%) and 16 (4.25%) in Group A versus none (0) in Group B.

CONCLUSION:

Mini-incision/invasive herniotomy in children and adolescents is fast, cost-effective with satisfactory cosmetic outcome and limited complications.

• Authors: Musa Ibrahim, Kabir Ibrahim Getso, Mohammad Aminu Mohammad, Nurlan Nurkenovich Akhparov, Rassulbek Rakhmanberdievich Aipov
• Journal: African journal of paediatric surgery : AJPS (Afr J Paediatr Surg) 2015 Jan-Mar Vol. 12 Issue 1 Pg. 45-50 ISSN: 0974-5998 [Electronic] India
• PMID: 25659550 (Publication Type: Journal Article, Randomized Controlled Trial, Video-Audio Media)

Topics

• Adolescent
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Hernia, Inguinal (congenital, surgery)
• Herniorrhaphy (methods)
• Humans
• Infant
• Laparoscopy (methods)
• Male
• Prospective Studies
• Suture Techniques (instrumentation)
• Sutures
• Time Factors
• Treatment Outcome
• Young Adult