A meta-analysis on the comparison between pediatric inguinal herniotomies performed with and without incising the external oblique aponeurosis in terms of recurrence and complications

RATIONALE@#There is a diversity of methods in performing pediatric inguinal herniotomy, but no consensus on which is the gold standard. The two most common are the Ferguson technique and the MitchellBanks technique. The objective of this meta-analysis was to compare the two techniques in terms of hernia recurrence and post-operative complications: namely hematoma, hydrocele, testicular ascent, and testicular atrophy.@*METHODS@#Three randomized controlled trials and one multi-center retrospective study were included in this meta-analysis. Using the Cochrane Collaboration tool and Newcastle-Ottawa quality assessment scale, all studies included were deemed to be of good quality and have low risk of bias. Revman 5.3 was used for all statistical analyses.@*RESULTS@#There was no significant difference in terms of hernia recurrence between the two techniques (OR = 0.85, 95% CI = 0.31- 2.36). For post-operative complications, hematoma (OR = 0.64, 95% CI = 0.37-1.13), testicular ascent (OR = 0.28, 95% CI = 0.05- 1.50), and testicular atrophy (OR = 2.02, 95% CI = 0.54-7.52) did not differ between the two techniques. Only the incidence of postoperative hydrocele significantly differed between the two techniques, being higher when the external oblique aponeurosis was opened (OR = 0.44, 95% CI = 0.27-0.70). @*CONCLUSION@# Performing pediatric inguinal herniotomy without opening the external oblique aponeurosis is a safe procedure and may be recommended as an optimal choice of method for uncomplicated cases.

Management of Wilms’ tumor in a horseshoe kidney at the time of COVID-19 pandemic: A case report

@#Wilms’ tumor is one of the most frequent tumors in childhood. The incidence of Wilms’ tumor in a horseshoe kidney is estimated at 0.4 to 0.9%. It is highly treatable but a fast growing tumor. Management of cancer patients has become a dilemma for surgeons, due to the impact of the COVID-19 pandemic on the health care sector globally. Reported here is a rare case of a 2 year old boy, diagnosed with Wilms’ tumor in a horseshoe kidney. This report aimed to highlight the multimodality treatment of Wilms' tumor and the modifications to cancer diagnostic and treatment protocols to adapt to the current health care crisis brought about by the pandemic.