title: Assessment of the necessity of sac high ligation in inguinal hernia open surgery among children.
abstract: BACKGROUND
  Pediatric inguinal hernia repair is the most common operation performed by surgeons. During open operation, rupture and retraction of the hernia sac may occur. Also, dislodgement of suture ligature or clamps may allow sac retraction into the abdominal cavity. In these situations, relegation of the retracting sac is not feasible, and further dissection and exploration may cause injury to the vas deferens and vessels.
  
  
  OBJECTIVE
  The purpose of this study was to compare inguinal hernia open surgery results in children with and without high ligation of the hernia sac with consideration of conditions and necessity.
  
  
  METHODS
  Of 330 hernias in 287 patients from March 2006 to March 2009 who had undergone open hernia repair, 100 patients (121 hernias) returned for regular follow-up. Of these patients, 13 were female, 87 were male, and ligation of the hernia sac was performed on 76% of cases (91 hernias). 24% of cases (30 hernias) were repaired without high ligation. Surgical method selection (ligation or no ligation) was due to the feasibility of sac ligation without consideration of ring size. Data were analyzed by SPSS software and Mann-Whitney U, Fisher's exact, and Chi-square statistical tests.
  
  
  RESULTS
  In 1-3 years of follow-up, no recurrences or complications that required intervention were found in any groups.
  
  
  CONCLUSIONS
  In the absence of recurrence and complications that require intervention, although there is no general consensus on no ligation in open repair, we propose to avoid high ligation of the inguinal sac in open surgery when it is not feasible.
authors.affiliation: Department of General Pediatric Surgery, Islamic Azad University of Mashhad, Mashhad, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Tabrizian
authors.forename: Seyed Mohammad Ali
authors.initials: SM
authors.lastname: Raisolsadat
authors.forename: Behrouz
authors.initials: B
authors.lastname: Houshmand
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Yaghubi
mesh_terms: D002648:Child; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male