title: Modified Marcy repair for indirect inguinal hernia in children: a 24-year single-center experience of 6826 pediatric patients.
abstract: OBJECTIVE
  To evaluate the management and outcomes of modified Marcy repair for inguinal hernia in a large series of children.
  
  
  METHODS
  We analyzed the case records of 6826 pediatric patients who underwent surgery for inguinal hernia between January, 1991 and January, 2015 at Split University Hospital in Croatia. The following parameters were examined: sex, age, location of the hernia, intraoperative or postoperative complications, recurrence, and surgical method.
  
  
  RESULTS
  The 6826 patients included 4751 boys and 2075 girls operated on for inguinal hernia. The mean age was 3.5 years, and mean followup was 14 years. Right-side predominance was noted with 59.50 % right hernia repairs, 33.72 % left hernia repairs, and 6.78 % bilateral hernia repairs. There were 6410 (93.90 %) elective procedures and 416 (6.10 %) emergency procedures for incarceration. The mean duration of surgery was 26 min (14-90 min), and the mean hospital stay was 1 day. Marcy repair was the most commonly performed operation (95.76 %), whereas Ferguson's technique was performed in only 3.98 % of the children. The overall recurrence rate was 0.43 %, with a recurrence rate of 0.36 % for Marcy repair and 1.83 % for Ferguson repair (p = 0.0003).
  
  
  CONCLUSIONS
  Modified Marcy hernia repair is a safe and effective procedure for inguinal hernia in children with excellent outcomes and a low incidence of recurrence.
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia. zpogorelic@gmail.com.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Pogorelić
authors.affiliation: School of Medicine, University of Split, Šoltanska 2, 21 000, Split, Croatia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Rikalo
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
authors.forename: Miro
authors.initials: M
authors.lastname: Jukić
authors.affiliation: School of Medicine, University of Split, Šoltanska 2, 21 000, Split, Croatia.
authors.forename: Josip
authors.initials: J
authors.lastname: Katić
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Jurić
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
authors.forename: Dubravko
authors.initials: D
authors.lastname: Furlan
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
authors.forename: Dražen
authors.initials: D
authors.lastname: Budimir
authors.affiliation: Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
authors.forename: Mihovil
authors.initials: M
authors.lastname: Biočić
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Children; Inguinal hernia; Marcy repair