Comparison of Early and Late Complications of the Mitchell-Banks Technique and Modified Ferguson Herniotomy in Children Over 2 Years of Age

Abstract

Setting and Duration: This retrospective comparative study was done at the Department of Pediatric Surgery, Qazi Hussain Ahmad Medical Complex (MTI Nowshera) between January 2019 and January 2024.

Methods: 190 children aged 2 to 16 years with primary inguinal hernia undergoing open surgical repair were enrolled. Patients received either Mitchell-Banks technique (MBT, n=95) or modified Ferguson herniotomy (FH, n=95) in two groups of equal size. Hospital records were used to determine demographic characteristics, operative parameters, and postoperative complications. Acute complications were poor wound healing, scrotal edema and hemorrhage, whereas late complications were recurrence, atrophy of testicles and chronic pain.

Results: The MBT group had a mean age of 5.12 ± 1.5 years and the FH group had a mean age of 6.33 ± 1.6, (p=0.015). The MBT group had a significantly less operative time (22.4 ± 3.1) as compared to FH group (30.2 ± 4.1, p=0.001). MBT group also had a shorter hospital stay (6.5 ± 2.1 hours) as compared to FH group (8.3 ± 2.7 hours, p<0.001). Early complications did not differ significantly between both groups on the basis of wound infection (2.1% vs 3.1%), scrotal edema (5.3% vs 6.3%) and hematoma (1.1% vs 2.1%). They recurrence was observed in 0% of MBT group patients in contrast to 3.1% of FH group (p=0.083).

Conclusion: The safety profiles of both the methods were similar with minimal cases of early and late complications. Though, Mitchellbanks technique showed lesser operating period as well as hospitalization, which indicated benefits on operative performance and recovery after the operation.