Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes Research

Background:

• Inguinal hernias are common in children, requiring surgical repair.
• Both laparoscopic surgery (LS) and open surgery (OS) are established treatment options.
• Understanding comparative outcomes is crucial for optimizing pediatric hernia management.

Purpose of the Study:

• To compare the outcomes of laparoscopic surgery (LS) versus open surgery (OS) for unilateral and bilateral pediatric inguinal hernias.
• To evaluate differences in recurrence rates, postoperative complications, and hospital stay between the two surgical approaches.

Main Methods:

• Analysis of a nationwide Japanese claim-based database (2005-2017).
• Inclusion of children under 15 years old who underwent inguinal hernia repair.
• Comparison of patient characteristics, reoperation rates, complications, hospital stay, and anesthesia duration between LS and OS groups.

Main Results:

• No significant difference in recurrence rates between OS and LS for both unilateral (0.2% vs. 0.3%) and bilateral (0.6% vs. 0.6%) hernias.
• Significantly lower incidence of metachronous hernias in the LS group compared to the OS group (1.0% vs. 4.8%).
• Surgical site infection rate was lower after OS for unilateral surgeries (0.9% vs. 2.2%), with no difference in hospital stay.

Conclusions:

• Both laparoscopic surgery and open surgery offer low recurrence rates for pediatric inguinal hernias.
• Laparoscopic surgery demonstrates a lower incidence of metachronous hernias, suggesting potential advantages.
• These findings may inform decisions regarding the preferred operative technique for pediatric inguinal hernia repair.