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Open versus minilaparoscopic herniorrhaphy for children: a prospective comparative trial with midterm follow-up
Yao Chou Tsai1, Chao-Chuan Wu, Stephen Shei-Dei Yang
1Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan. tsai0523@ms29.url.com.tw
Insights
Minilaparoscopic hernia repair in children shows better outcomes than open repair. This method reduces the risk of contralateral hernias and increases patient satisfaction.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Prospective clinical trial comparing open repair (OR) and minilaparoscopic repair (MR) for pediatric inguinal hernias.
- Focus on midterm surgical and functional outcomes.
Purpose of the Study:
- To compare midterm surgical and functional results of open versus minilaparoscopic inguinal hernia repair in children.
- Evaluate recurrence rates, pain, complications, and patient satisfaction.
Main Methods:
- 174 children with inguinal hernias prospectively enrolled (65 OR, 109 MR) between May 2005 and May 2008.
- Postoperative functional status, pain, complications, and satisfaction documented.
- 35 patients lost to follow-up; mean follow-up of 2 years.
Main Results:
- Minilaparoscopic repair (MR) showed comparable recurrence rates, pain, complications, and functional recovery to open repair (OR).
- MR group had zero contralateral metachronous inguinal hernias versus 9.7% in OR group (p=0.02).
- MR group reported higher overall patient satisfaction (p=0.03).
Conclusions:
- Minilaparoscopic herniorrhaphy is superior to open repair for pediatric inguinal hernias.
- Minilaparoscopic repair effectively prevents contralateral hernia occurrence.
- Minilaparoscopic repair leads to greater overall patient satisfaction.
Background:
A prospective clinical trial was designed to compare the midterm surgical and functional results between open (OR) and minilaparoscopic (MR) herniorrhaphy repairs for pediatric inguinal hernia.
Methods:
Between May 2005 and May 2008, 174 children with inguinal hernias were prospectively enrolled for either open or minilaparoscopic hernia repair. Of these children, 65 underwent open herniorrhaphy and 109 underwent minilaparoscopic herniorrhaphy. The postoperative functional status, pain, complications, and overall satisfaction were documented at outpatient clinic visits for analysis.
Results:
During the study period, 35 patients were lost to follow-up evaluation and thus excluded. The mean follow-up period was about 2 years, and the baseline characteristics were matched between the two groups. The patients in the MR group had recurrence rates, postoperative pain, complications, and functional recovery comparable with those in the OR group. None in the MR patients experienced a contralateral metachronous inguinal hernia compared with 9.7% of the OR patients (p = 0.02). The MR patients had a higher rate of overall satisfaction than the OR patients (p = 0.03).
Conclusions:
Minilaparoscopic herniorrhaphy was superior to open repair with regard to prevention of contralateral hernia occurrence and overall satisfaction.
