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.

OBJECTIVE

This seven-year, two-center retrospective cross-sectional study aimed to describe the demographic, clinical characteristics and surgical indications of patients managed with open or laparoscopic cholecystectomy in the pediatric age group, and determine these variables’ associations with patient outcomes.

METHODS

Records of all patients less than 19 years old who underwent laparoscopic or open cholecystectomy at Jose R. Reyes Memorial Medical Center (JRRMMC) and National Children’s Hospital (NCH) from January 2015 to December 2021 were reviewed. The gathered data were organized, described and analyzed using univariate and multivariate statistics.

RESULTS

A total of 32 patients underwent open or laparoscopic cholecystectomy at the two institutions. Majority were female (78.1%). The diagnoses included chronic calculous cholecystitis (62.5%), acute calculous cholecystitis (21.9%), choledocholithiasis (12.5%). One (3.1%) patient had empyema of the gallbladder. The 15 – 18 year age group made up 78.1%, with the rest (21.9%) from the 10 – 14 year age group. By BMI percentile, 62.5% were normal, 15.6% were overweight, and 12.5% were obese. Most patients across all conditions (96.9%) had no known hemolytic disorder. Underweight patients (9.4% of the cohort) had statistically higher lengths of stay [F(3,28) = 3.444, p = .030]. No significant associations were found between the categorical outcomes (discharged well, morbidity, mortality) and patient variables (age group, sex, BMI percentile, presence of co-morbidities, symptoms, indication for surgery, operation done).

CONCLUSION

In pediatric patients undergoing laparoscopic or open cholecystectomy, BMI percentile is inversely related to the length of hospital stay.

Human ; Cholecystectomy ; Gallbladder Diseases ; Demography