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Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis
1Faculty of Medicine, King Khalid University Hospital, King Saud University, P.O. Box 7805 (37), Riyadh, 11472, Saudi Arabia. aalzahem@ksu.edu
Insights
Laparoscopic inguinal hernia repair in children shows a trend toward higher recurrence but reduces contralateral hernias. Further research is needed to compare surgical approaches for pediatric inguinal herniotomy.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Hernia repair
Background:
- Inguinal hernias are common in infants and children.
- Surgical repair is the standard treatment.
- Laparoscopic and open approaches are available.
Purpose of the Study:
- To compare laparoscopic versus open inguinal herniotomy in pediatric patients.
- To synthesize evidence from comparative studies.
Main Methods:
- Meta-analysis of randomized controlled trials and observational studies.
- Searched MEDLINE, EMBASE, and Cochrane Central.
- Included children under 19 years undergoing inguinal hernia repair.
Main Results:
- Analyzed data from 2,699 children across 10 studies.
- Laparoscopic repair showed a trend towards higher recurrence rates (OR = 1.81).
- Laparoscopic repair had longer operative times for unilateral cases (WMD = 10.23) but shorter for bilateral (WMD = -4.54).
- Significantly reduced contralateral metachronous hernias with laparoscopy (OR = 0.37).
Conclusions:
- Laparoscopic inguinal herniotomy is linked to longer unilateral operative times and fewer metachronous hernias.
- A trend towards increased recurrence with laparoscopy was observed.
- A high-quality randomized controlled trial is recommended for definitive comparison.
Purpose:
To undertake a meta-analysis of comparative data of laparoscopic versus open inguinal herniotomy in infants and children.
Methods:
We searched MEDLINE, EMBASE, and The Cochrane Central Controlled Trials Registry for relevant randomized controlled trials and observational studies comparing laparoscopic with open inguinal hernia repair in children aged less than 19 years.
Results:
Data on 2,699 children were identified from 10 comparative studies. Laparoscopic techniques were associated with a trend towards higher recurrence rate (OR = 1.81; 95% CI 0.89-3.67; p = 0.10), longer operative time for unilateral repairs (WMD = 10.23; 95% CI 8.82-11.64; p < 0.00001), and may be shorter operative time for bilateral repairs (WMD = -4.54; 95% CI -11.63 to 2.55; p = 0.21). There was a significant reduction in developing a contralateral metachronous inguinal hernia in the laparoscopic group (OR = 0.37; 95% CI 0.20-0.67; p = 0.001).
Conclusions:
Laparoscopic inguinal herniotomy is significantly associated with longer operative time for unilateral cases and a reduction in metachronous hernia development. There was a trend towards higher recurrence rate for laparoscopic repairs and shorter operative time for bilateral cases. A well conducted randomized controlled trial is warranted to compare both approaches.
