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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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LETTERS TO THE EDITOR
Year : 2023  |  Volume : 28  |  Issue : 1  |  Page : 85
 

Pediatric umbilical hernia: Is repair with continuous suture safe?


Department of Pediatric Surgery, Albert Royer National Children's Hospital Center, Cheikh Anta Diop University, Dakar, Senegal

Date of Submission15-Nov-2022
Date of Acceptance17-Nov-2022
Date of Web Publication10-Jan-2023

Correspondence Address:
Florent Tshibwid A. Zeng
52x65 Streets, Gueule Tapée, Dakar
Senegal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.jiaps_152_22

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How to cite this article:
A. Zeng FT, Gueye D, Ndoye NA, Mbaye PA, Iq-Lefqih O, Sagna A, Ngom G. Pediatric umbilical hernia: Is repair with continuous suture safe?. J Indian Assoc Pediatr Surg 2023;28:85

How to cite this URL:
A. Zeng FT, Gueye D, Ndoye NA, Mbaye PA, Iq-Lefqih O, Sagna A, Ngom G. Pediatric umbilical hernia: Is repair with continuous suture safe?. J Indian Assoc Pediatr Surg [serial online] 2023 [cited 2023 Feb 2];28:85. Available from: https://www.jiaps.com/text.asp?2023/28/1/85/367382




Sir,

Umbilical hernia is a common disease in African children, in whom it is usually symptomatic, so that its systematic repair after diagnosis was recommended by some authors.[1],[2],[3] The main aim of hernia repair is the defect closure. For umbilical hernia, it can be practiced using three kind of sutures: purse string, continuous, or interrupted sutures.[4] However, comparative studies of these different techniques are scarce.

Therefore, we conducted a comparative analytic study in the two main departments of pediatric surgery in Senegal, at Albert Royer National Children's Hospital Centre and Aristide Le Dantec, both University Teaching Hospitals. From July 1 to December 15, 2017, we included 100 patients, whose mean age was 5.7 years, with 60% of males, and 27% with symptomatic umbilical hernia. They were subdivided into two groups depending on kind of repair suture (interrupted vs. continuous), with random appurtenance to either group. After 2-month follow-up, no postoperative complication, including recurrence, was noted in either group. Concerning operative duration, comparison between the two groups using Fisher's exact test showed a shorter time for continuous suture (30.9 ± 10.19 min) compared to interrupted sutures (41.4 ± 11.31 min), p = 0.0001.

Umbilical hernia repair using interrupted sutures was popularized due to its security, preventing recurrence grace to multiple stitches. Nevertheless, formally identified factors associated with recurrence are emergency admission, repair before 4-years-old, and postoperative hospitalization.[5] With our study, we demonstrated equivalence of both techniques in terms of postoperative complications and recurrence. However, repair using interrupted suture was longer, since multiple stitches were made.

For pediatric umbilical hernia repair, continuous suture is a safe method, faster than the one using interrupted sutures. Consequently, we recommend it to pediatric surgeons.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Ngom G, Gassama F, Kane A, Seck M, Ndour O, Ndoye M. Clinical and surgical aspects of strangulated umbilical hernias in children: A prospective study of 35 cases. J Pediatr Surg Spec 2010;4:20-2.  Back to cited text no. 1
    
2.
Harouna Y, Gamatie Y, Abarchi H, Bazira L. Umbilical hernia in black children : symptoms and outcome of treatment about 52 cases. Med Afr Noire 2001;48:269-9.  Back to cited text no. 2
    
3.
Ngom G. Umbilical hernia in African children: Same attitude than that of inguinal hernia. J Indian Assoc Pediatr Surg 2006;11:255.  Back to cited text no. 3
  [Full text]  
4.
El Diehy TM, El Azazy HE Den, El Hofy AN, Ahmed MH. Surgical repair of umbilical hernia in children. Egypt J Hosp Med 2018;72:4927-31.  Back to cited text no. 4
    
5.
Halleran DR, Minneci PC, Cooper JN. Association between age and umbilical hernia repair outcomes in children: A multistate population-based cohort study. J Pediatr 2020;217:125-30.e4.  Back to cited text no. 5
    




 

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