The effect on postoperative pain of pulling the rectus muscle medially during open appendectomy surgery.

AIM: We investigated whether pulling the rectus muscle medially during open appendectomy surgery had any effect on postoperative pain in this study. METHODS: This prospective study was performed on patients 6 years and older who were admitted for acute appendicitis. The patients were divided into two groups, open appendectomy was performed by pulling the rectus muscle medially in the first group and splitting the rectus muscle in the second group. Pain was evaluated in both groups at preoperative and 12 and 24 hour postoperative by using a visual analog scale graded. RESULTS: The first group consisted of 31 and the second group of 30 patients. The preoperative and 12 and 24 hour postoperative pain evaluation results were 8.25 ± 1.03, 2.96 ± 1.40 and 1.16 ± 0.93 in the first group and 8.36 ± 0.99, 4.90 ± 1.24 and 2.03 ± 1.06 respectively in the second group. There was no statistically significant difference between the two groups for age, gender, inpatient duration and preoperative pain scores while the 12 and 24 hour postoperative pain scores were lower in the first group than the second group. This difference was statistically significant (P<0.05). CONCLUSION: Performing the appendectomy by pulling the rectus muscle medially in clinics using open appendectomy will provide a more comfortable postoperative period for the children.

Sliding hernias in female children.

INTRODUCTION: Articles published in the English language report that 15-20% of the inguinal hernias in female children are sliding hernias. These studies do not specify the age at moment of surgery, neither the age distribution of sliding hernia. We retrospectively evaluated inguinal canal pathologies to answer these questions. MATERIAL AND METHOD: We retrospectively evaluated the records of the patients operated on at the Pediatric Surgery Clinics of the Ordu, Usak and Denizli State Hospitals and the Afyon Obstetrics and Gynecology Hospital. RESULTS: A total of 3105 cases had been operated on for an inguinal hernia between January 2008 and December 2010 and 673 (21.6%) were female. The most common age at surgery was between 0 and 1 years (26.5%). A sliding hernia was found in 22.4% (n = 151) of all cases. The sliding hernia rate was 45.8 (n = 82) and 14.9% (n = 69) in children younger and older than 1 year of age respectively (p < 0.05). The most frequently sliding organ in both groups was the ovary, followed by the fallopian tubes. CONCLUSION: A sliding hernia is more common in female children under the age of 1 year and surgical treatment should be planned within a short period once the diagnosis is made. In addition, this recent statistical value for subjects aged 0 to 1 year and over 1 year can be used in new clinical studies.