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Laparoscopic versus open herniorrhaphy for children with inguinal hernia: A meta-analysis of randomized controlled
Guoqing Liu1, Wenxian Zhang, Jianfeng Zhou
1Department of General Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Laparoscopic herniorrhaphy (LH) offers protection against major postoperative complications compared to open herniorrhaphy (OH) in children. LH also resulted in shorter operative times for bilateral hernias but longer discharge times.
Area of Science:
- Pediatric surgery
- Minimally invasive procedures
- Hernia repair
Background:
- Inguinal hernia is a common condition in children.
- Surgical repair is the standard treatment.
- Comparing different surgical approaches is crucial for optimal outcomes.
Purpose of the Study:
- To compare the effectiveness of laparoscopic herniorrhaphy (LH) versus open herniorrhaphy (OH) in pediatric patients.
- To evaluate postoperative complication rates and recovery times.
- To analyze operative times for unilateral and bilateral inguinal hernias.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched PubMed, EmBase, and Cochrane Library up to April 2019.
- Evaluated relative risks and weighted mean differences with 95% confidence intervals.
Main Results:
- Six RCTs involving 594 children were analyzed.
- LH significantly reduced major postoperative complications compared to OH.
- LH was associated with shorter operative times for bilateral hernias but longer discharge times.
Conclusions:
- Laparoscopic herniorrhaphy provides superior protection against major postoperative complications in children.
- LH demonstrates potential benefits in operative time for bilateral cases.
- Further consideration of discharge duration is warranted for LH.
Purpose:
The aim of this study was to compare the effectiveness between laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in children with inguinal hernia.
Methods:
PubMed, EmBase, and the Cochrane library were searched to select trials from their inception till April 2019. The summary of relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were employed to evaluate the treatment effectiveness between LH and OH.
Results:
Six randomized controlled trials (RCTs) including a total of 594 children were selected. No significant differences were observed between LH and OH regarding the risk of postoperative complications. However, LH significantly reduced the risk of major postoperative complications when compared with OH. Moreover, LH showed association with a shorter operative time in bilateral inguinal hernia when compared with OH, whereas no significant difference between groups for unilateral inguinal hernia. Finally, children who received LH showed association with longer time to discharge than those who received OH, whereas no significant difference was observed between the groups for time to resume full activity.
Conclusions:
These findings suggested that children who received LH had protection against major postoperative complications than those who received OH. Moreover, children who received LH had shorter operative time, and longer time to discharge.
