Laparoscopic versus open inguinal hernia repair in children: which is the true gold-standard? A systematic review and...

Area of Science:

• Pediatric surgery
• Minimally invasive surgery
• Surgical outcomes

Background:

• Hernia repair is a common pediatric operation.
• Open surgical repair is traditional, but laparoscopic repair is increasingly favored.
• Comparing outcomes of open versus laparoscopic pediatric hernia repair is crucial.

Purpose of the Study:

• To compare recurrence rates and other outcomes between open and laparoscopic hernia repair in children.
• To determine the optimal surgical approach for pediatric inguinal hernia repair.

Main Methods:

• A systematic review and meta-analysis of studies comparing laparoscopic and open pediatric inguinal hernia repair.
• Searched CENTRAL, MEDLINE, and EMBASE databases from 1980 onwards.
• Included 21 studies in the meta-analysis after reviewing 345 unique citations.

Main Results:

• Laparoscopic repair was associated with higher rates of wound infection (p=0.003).
• Laparoscopic repair showed lower rates of ascending testis (p=0.05) and metachronous hernia (p=0.0002).
• No significant differences were found in recurrence rates, surgical time, or hospitalization length between the two methods.

Conclusions:

• Open and laparoscopic hernia repair are comparable regarding recurrence rates, surgical time, and hospitalization.
• Laparoscopic repair offers benefits in reducing ascending testis and metachronous hernia risks.
• Laparoscopic surgery's ability to address the contralateral side can prevent metachronous hernias, despite a higher risk of wound infection.