Inguinal herniotomy in children: Retrospective three decades experience

Abstract

Context: Inguinal herniotomy is the most frequently performed operation in the pediatric age group. The clinical outcome of inguinal hernias and hydroceles in pediatric patients should be assessed periodically. Aims: This study aims to analyze the clinical presentation and outcome of a large series of pediatric inguinal hernias and hydroceles from a tertiary care institute. Settings and Design: A retrospective study performed on cohort of pediatric patients with inguinal hernias and hydroceles from January 1983 to December 2014. Subjects and Methods: Pediatric patients, aged <16 years with inguinal hernias and hydroceles were studied. Results: There were 8000 pediatric patients with 7350 (91.875%) males and 650 (8.125%) females (M:F = 11.3:1). Only 60 (0.75%) were in neonatal age group and 1770 (22.125%) were infants. Out of 8000, 170 (2.125%) patients presented with incarcerated inguinal hernia. A total of 8260 herniotomies were performed which included 260 cases with bilateral disease. Inguinal hernia constituted 6195 (75%) patients and hydrocele in 2065 (25%) cases. Associated genital anomalies and abdominal wall defects were present in 252 (3.15%) cases. In 80 (1%) patients, additionally ipsilateral orchiopexy were performed for unilateral undescended testis in 76 (0.95%) patients and unilateral ectopic testis 4 (0.05%) patients. Postoperative complications were present in 48 (0.6%) cases. Conclusions: Complications associated with inguinal hernias including those presenting with incarceration and strangulation are rare if they are managed in time and under the supervision of an experienced pediatric surgeon. We recommend a yearly clinical audit (assessment of morbidity and mortality statistics) of pediatric inguinal hernias and hydroceles managed with inguinal herniotomy.