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Published on: November 12, 2021
Long-term outcomes of pediatric laparoscopic needled-assisted inguinal hernia repair: A 10-year experience
Denise I Garcia1, Charles Baker1, Sahil Patel1
1Medical University of South Carolina, Charleston, SC.
Insights
Laparoscopic needle-assisted repair (LNAR) is a safe and effective pediatric hernia repair. This study shows low recurrence rates and good outcomes, especially for preterm infants, over an 11-year follow-up.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Laparoscopic inguinal hernia repair (LIHR) is increasingly used in children.
- Long-term follow-up data for LIHR, particularly the needle-assisted technique, is limited.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of laparoscopic needle-assisted repair (LNAR) in pediatric patients.
- To present one of the largest cohorts of children undergoing LNAR with extended follow-up.
Main Methods:
- Retrospective review of a clinical quality database for children (≤14 years) who underwent LNAR between 2009 and 2017.
- Analysis of follow-up data through 2019, including recurrence rates and complications.
- Level III - Retrospective Comparative Study.
Main Results:
- 1023 patients with 1457 LNAR procedures were analyzed.
- Overall hernia recurrence rate was 0.75% (11/1457) with a mean follow-up of 5.97 years (up to 11 years).
- Preterm infants repaired before 60 weeks post-conceptional age showed a significantly lower recurrence rate (0.63%) compared to other patients (0.82%).
Conclusions:
- LNAR is a safe and effective surgical option for pediatric inguinal hernias in both term and preterm infants.
- Complication rates for LNAR are comparable to other techniques, including open repair.
- Preterm infants may experience superior outcomes with LNAR compared to other repair methods.
Purpose:
Laparoscopic inguinal hernia repair (LIHR) has gained wide acceptance over the past decade, although studies with longer term follow-up are lacking. We present one of the largest cohorts of children undergoing laparoscopic needle-assisted repair (LNAR) with long-term follow-up.
Methods:
A clinical quality database was maintained for children ≤14 years of age who underwent laparoscopic needle-assisted repair between 2009 and 2017 with review of follow-up through 2019. De-identified data was reviewed.
Results:
1023 patients with 1457 LNAR were included during the 10-year period. Mean age at surgery was 2.56 years (2 days to14 years). The overall hernia recurrence rate was 0.75% (11/1457). A total of four postoperative hydroceles required intervention. Preterm infant repair done <60w post conceptional age had a significantly lower recurrence rate (0.63%) than other patients (0.82%) (p < 0.01). 64.2% of patients had clinical follow-up over a period of 11 years with a mean follow-up of 5.97 years.
Conclusion:
We present a large cohort study of consecutive pediatric laparoscopic hernia repairs followed over an 11-year period. LNAR is safe and effective for term and preterm patients with similar complication rates to other techniques, including open repair. Additionally, our results suggest that preterm infants may have superior outcomes with this method.
Level Of Evidence:
Level III - Retrospective Comparative Study.
