A meta-analysis on the comparison between pediatric inguinal herniotomies performed with and without incising the external oblique aponeurosis in terms of recurrence and complications.
- Author:
Samuel Victor Celi Tan
;
Antonio D. Catangui
;
Nino P. Isabedra
- Publication Type:Meta-Analysis
- Keywords:
Pediatric herniotomy;
Mitchell-Banks
- From:
Philippine Journal of Surgical Specialties
2021;76(2):79-86
- CountryPhilippines
- Language:English
-
Abstract:
RATIONALE:There is a diversity of methods in performing pediatric
inguinal herniotomy, but no consensus on which is the gold standard.
The two most common are the Ferguson technique and the MitchellBanks technique. The objective of this meta-analysis was to compare
the two techniques in terms of hernia recurrence and post-operative
complications: namely hematoma, hydrocele, testicular ascent, and
testicular atrophy.
METHODS:Three randomized controlled trials and one multi-center
retrospective study were included in this meta-analysis. Using
the Cochrane Collaboration tool and Newcastle-Ottawa quality
assessment scale, all studies included were deemed to be of good
quality and have low risk of bias. Revman 5.3 was used for all
statistical analyses.
RESULTS:There was no significant difference in terms of hernia
recurrence between the two techniques (OR = 0.85, 95% CI = 0.31-
2.36). For post-operative complications, hematoma (OR = 0.64,
95% CI = 0.37-1.13), testicular ascent (OR = 0.28, 95% CI = 0.05-
1.50), and testicular atrophy (OR = 2.02, 95% CI = 0.54-7.52) did
not differ between the two techniques. Only the incidence of postoperative hydrocele significantly differed between the two techniques,
being higher when the external oblique aponeurosis was opened
(OR = 0.44, 95% CI = 0.27-0.70).
CONCLUSION: Performing pediatric inguinal herniotomy without
opening the external oblique aponeurosis is a safe procedure and may
be recommended as an optimal choice of method for uncomplicated
cases.
- Full text:A meta-analysis on the comparison.pdf
