Çocuklarda İnguinal Herni Onarımının Komplikasyonarı: 8265 Olgunun Değerlendirilmesi

Year 2012, Volume: 6 Issue: 1, 13 - 18, 01.12.2012

Tuğrul Tiryaki Müjdem Nur Azılı Fatma Özcan Ziya Livanelioğlu Evrin Mambet Fatih Akbıyık Emrah Şenel Sengül Özmert Sibel Saydam Halil Atayurt

Abstract

Amaç: İnguinal herni onarımı çocuk cerrahisi pratiğinde en sık yapılan cerrahi girişim olmasına karşı herni onarımına bağlı komplikasyonlarla ilgili oldukça az yayın vardır. Çalışmamızda inguinal herni onarımı nedeni ile belirlediğimiz operatif komplikasyonlar değerlendirilerek, nedenlerinin irdelenmesi amaçlandı.Yöntem ve Gereç: 2000–2009 yılları arasında kliniğimizde inguinal herni tanısı ile opere edilen 8265 olgu hastane kayıtlarından geriye doğru değerlendirmeye alındı.Bulgular: 8265 olguda 9125 inguinal herni onarımı yapıldı. Olguların 6517’i (%78.8) erkek 1748’i (%21.2) kız idi. Operasyon yaşı 5 gün ile 20 yaş arasında idi. 125 olguda (%1.5) operatif komplikasyon ile karşılaşıldı. Operatif komplikasyon olduğu saptanan olgularımızın yaş ortalaması 2 yaş idi ve %30’unun bir yaşın altında olduğu görüldü. 55 olguda (%0.66) yara yeri enfeksiyonu belirlendi. 37 olguda (%0.44) herni nüksü saptandı. 5 olguda (% 0.07) reoperasyon gereken iatrojenik inmemiş testis gelişti. 67 olgu karşı tarafta gelişen herni nedeni ile opere edildi (%0.9).Sonuçlar: Serimizde literatürle karşılaştırıldığında komplikasyon oranının çok az olduğu görülmektedir. Diseksiyon sırasında fıtık kesesi kaçan olgularda Zigg prosedürü ile yapılan onarım nüks oranının düşük olmasının nedenidir. Kliniğimizde operasyon için bekleme süresinin olmaması, inkarsere olguların ve buna bağlı olarak komplikasyonların az görülmesini sağlamaktadır.

Keywords

İnguinal herni, komplikasyon, çocuk

COMPLICATIONS OF THE INGUINAL HERNIA REPAIR IN CHILDREN: EVALUATION OF THE 8265 PATIENTS

Abstract

Background: Inguinal hernia repair is the most common operation performed in pediatric surgery practise, but there are few reports about the complications of this operation. The aim of this study was to evaluate the incidence and the etiology of complications following inguinal herniotomy in chilhood.Methods: The operative and clinical notes of 8265 children operated from the begining of 2000 to the end of 2009 were reviewed retrospectively. Results: 9125 indirect inguinal hernias were repaired in 8265 patients. There were 6517 (78.8%) boys and 1748 (21.2 %) girls. The age at operation ranged from 5 days to 20 years. Operative complications were noted in 125 (1.5%) patients. The mean age of patients with operative complications was 2 years and 30% of these patients were younger than 1 year old. Among all patients with operative complications, 55 patients had wound infections (0.66%), 37 cases of recurrence was noted following hernia repair (0.44%), 5 cases of iatrogenic testicular (0.07%) ascent were required orchiopexy after hernia repair, and contralateral hernias emerged in 67 (0.9%) patients after unilateral hernia operation. Conclusions: In our series, complication rates were very low according to the literature. Use of Zigg procedure to close the hernia sac in patients with larger hernial sacs and sacs inadvertently opened during surgery decreased the recurrence rate. There is no prolonged time before surgery of inguinal hernia repair for infants in our clinic. This could be an explanation of low incarceration and also low complication rates in our series when compared to other series

Keywords

Inguinal hernia, complication, childhood

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