Outcomes following laparoscopic versus open surgery for pediatric inguinal hernia repair: Analysis using a national...

Area of Science:

• Pediatric Surgery
• Surgical Outcomes Research

Background:

• Pediatric inguinal hernia repair is commonly performed using either laparoscopic surgery (LS) or open surgery (OS).
• Comparative data on perioperative outcomes between LS and OS in children is crucial for surgical decision-making.

Purpose of the Study:

• To compare perioperative outcomes, including complications, recurrence, and metachronous hernia (MH) rates, between laparoscopic surgery (LS) and open surgery (OS) for pediatric inguinal hernia repair.
• To analyze data from a national inpatient database to provide evidence-based insights.

Main Methods:

• Retrospective analysis of a national inpatient database (Diagnosis Procedure Combination) in Japan.
• Inclusion of 75,486 children undergoing inguinal hernia repair between July 2010 and March 2016.
• Utilized multivariable logistic regression for complications and Cox regression for recurrence analysis.

Main Results:

• Laparoscopic surgery (LS) demonstrated a significantly lower proportion of metachronous hernias (MH) compared to open surgery (OS) (0.3% vs. 3.4%).
• Anesthesia duration varied: longer for unilateral LS, shorter for bilateral LS compared to OS.
• No significant differences were observed in postoperative complications (OR: 0.55; 95% CI: 0.22-1.38) or recurrence rates (HR: 1.24; 95% CI: 0.86-1.79) between LS and OS.

Conclusions:

• Laparoscopic surgery (LS) is associated with a reduced incidence of metachronous hernias (MH) in pediatric inguinal hernia repair.
• Perioperative complications and hernia recurrence rates do not significantly differ between laparoscopic surgery (LS) and open surgery (OS).
• The findings support LS as a viable option with potential benefits regarding MH development.