Comparison between inguinal herniotomies with and without incising external oblique muscle fascia in male children diagnosed with inguinal hernia in Alborz Imam Ali hospital during September to December 2020

Inguinal herniotomy is the most common surgery performed by pediatric surgeons. Due to the lack of sufficient studies comparing herniotomy methods, this study aimed to compare two herniotomy methods with and without incising external oblique muscle fascia in terms of intraoperative and postoperative complications and operation time.

This single-blind randomized clinical trial study was conducted on 111 male-children with inguinal hernia who referred to Imam Ali Alborz hospital from September to December 2020, by convenience sampling method. 102 patients had unilateral hernia (91.89%) and 9 patients had bilateral hernia (8.11%) which each side was operated by different method, finally total number of surgeries was 120 cases. In the first group, 60 patients were operated with incising and in the second group, 60 patients without incising external oblique muscle fascia. Recorded data were analyzed using Chi-square and Mann-Whitney U test with a significance level of less than 0.05 in SPSS-21 software.

The complication incidence rates, based on the type of surgery - with and without incising external oblique aponeurosis - the results were, respectively: a) Ileoinguinal nerve damage, n=1 (1/7%) vs. n=0; b) scrotal edema, n=3 (5%) vs n=1 (1.7%); c) fever, n=0 vs n=1 (1.7%). complications between two method had no significant difference. Average of with incising method time was longer and had significant difference.

Herniotomy without incising the fascia has a shorter operation time (2.35 minutes). There was no significant difference in terms of complications, so without incising method can be the appropriate choice than with incising oblique aponeurosis.