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Published on: December 23, 2022
Characteristics and treatments for pediatric ordinary and incarcerated inguinal hernia based on gender: 12-year
Kai Wang1, Sarah Siyin Tan1, Yue Xiao1
1Department of General Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi St, Xicheng District, Beijing, 100045, China.
Insights
Open inguinal hernia repair (OIHR) is recommended for male pediatric patients, while laparoscopic inguinal hernia repair (LIHR) is preferred for females. Incarcerated hernias require special attention in infants and females.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- Congenital primary inguinal hernia is a common pediatric condition.
- Large-scale analyses, particularly examining gender differences and incarcerated hernias, are limited.
Purpose of the Study:
- To compare outcomes of open inguinal hernia repair (OIHR) and laparoscopic inguinal hernia repair (LIHR).
- To investigate gender-specific differences and factors associated with incarcerated inguinal hernias in pediatric patients.
Main Methods:
- Retrospective analysis of medical records for 12,190 pediatric patients undergoing OIHR or LIHR.
- LIHR utilized single-site laparoscopic percutaneous extraperitoneal closure (SLPEC).
Main Results:
- OIHR demonstrated shorter operative times for unilateral and female bilateral repairs, but not for male bilateral repairs.
- Incarcerated inguinal hernias were linked to longer operative times, hospital stays, and costs.
- Infants (<1 year) and females were more prone to incarcerated hernias.
Conclusions:
- OIHR is suggested for male pediatric patients, especially for unilateral hernias.
- LIHR is highly recommended for female pediatric patients.
- Infants and females require heightened awareness for incarcerated hernias, with surgeons noting potential for ovary hernias in females.
Background:
Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias.
Methods:
Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. LIHR was performed using single-site laparoscopic percutaneous extraperitoneal closure (SLPEC). Medical records were retrospectively collected and analyzed.
Results:
A total of 12,190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10,646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12,444 hernia repair surgeries, 11,083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia. Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.
Conclusions:
OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.
