Comparison of inflammatory stress response between laparoscopic and open approach for pediatric inguinal hernia...

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Inflammatory Response

Background:

• Pediatric inguinal hernias are common surgical conditions.
• Surgical repair techniques aim to minimize patient stress and recovery time.
• Comparing inflammatory responses between different surgical approaches is crucial for optimizing pediatric care.

Purpose of the Study:

• To compare the inflammatory stress response between laparoscopic percutaneous inguinal ring suturing (PIRS) and the open modified Marcy technique for pediatric inguinal hernia repair.
• To evaluate key inflammatory biomarkers including white blood cells (WBC), C-reactive protein (CRP), Interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α).
• To assess operative time and postoperative pain as secondary outcomes.

Main Methods:

• A randomized controlled trial involving 32 male children undergoing inguinal hernia repair.
• Patients were allocated to either the PIRS or modified Marcy group.
• Blood samples were analyzed for inflammatory biomarkers at multiple time points post-surgery.

Main Results:

• All tested inflammatory biomarkers (WBC, CRP, IL-6, TNF-α) showed a significant increase over time.
• The modified Marcy technique resulted in significantly higher levels of WBC, CRP, and IL-6 compared to PIRS.
• PIRS demonstrated significantly shorter operative times and lower visual analog scale (VAS) pain scores than the Marcy technique.

Conclusions:

• Laparoscopic PIRS technique leads to a significantly lower surgical stress response in children compared to open hernia repair.
• PIRS is associated with reduced inflammation, shorter procedure duration, and less postoperative pain.
• These findings support the use of PIRS as a preferred method for pediatric inguinal hernia repair.