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Laparoscopic simultaneous inguinal hernia repair and appendectomy in children: A multicenter study
Yibo Li1, Zhaokun Guo2, Zhenfan Qu3
1Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Laparoscopic simultaneous repair of inguinal hernias and appendectomy in children is safe and effective. This combined approach reduces operative time, hospital stay, and costs without increasing complications.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Inguinal hernias (IHs) are occasionally found incidentally during laparoscopic appendectomy in children.
- Evaluating the efficacy of simultaneous laparoscopic inguinal hernia repair and appendectomy is crucial.
Purpose of the Study:
- To assess the safety and effectiveness of performing laparoscopic inguinal hernia repair and appendectomy simultaneously in pediatric patients.
- To compare outcomes of simultaneous procedures versus two-stage laparoscopic interventions.
Main Methods:
- A multicentric study compared 117 children undergoing simultaneous laparoscopic procedures with 72 children undergoing two-stage procedures for appendicitis (AA) and concurrent IH.
- Data on intraoperative details, postoperative complications, and clinical outcomes were collected and analyzed.
- Level III evidence was utilized.
Main Results:
- The simultaneous group showed shorter operative times (43.2 min vs. 53.9 min) and hospital stays (1.5 days vs. 2.2 days) compared to the two-stage group.
- Simultaneous procedures resulted in significantly lower costs (9198.7 RMB vs. 14,392.5 RMB).
- Wound infection rates (3 vs. 2) and recurrent IH (1 vs. 0) were similar between groups, with no significant increase in complications.
Conclusions:
- Laparoscopic simultaneous inguinal hernia repair and appendectomy is a safe, feasible, and cost-effective option for children.
- This approach avoids repeat anesthesia and hospitalization, offering significant benefits.
- The combined procedure does not elevate the risk of wound infection or hernia recurrence.
Background:
Inguinal hernias (IHs) are sometimes encountered incidentally in children during laparoscopic appendectomy. This study aims to evaluate the efficacy and outcomes of laparoscopic simultaneous inguinal hernia repair and appendectomy in children.
Methods:
A multicentric study was performed in patients with AA and concurrent IH who received laparoscopic simultaneous inguinal hernia repair and appendectomy (study group), compared with patients who underwent two-stage laparoscopic procedures (control group) between September 2012 and January 2020. Intraoperative data, postoperative complications, and clinical outcomes were prospectively collected and retrospectively analyzed.
Results:
189 patients with AA and concurrent IH (117 children in the study group, and 72 children in the control group) were enrolled. No significant differences in preoperative characteristics were identified between the two groups. Patients in the study group had a shorter total operative time and hospital stay than those in the control group (43.2 ± 8.1 vs 53.9 ± 7.3 min, p < 0.001; 1.5 ± 0.8 vs 2.2 ± 0.9 days, p = 0.023). The study group incurred lower costs than the control group (9198.7 ± 587.6 vs 14,392.5 ± 628.6 RMB, p < 0.001). During follow-up (range 1.5-6.0 years), three children in the study group and two children in the control group experienced wound infection. One child in the study group had recurrent IH.
Conclusions:
Laparoscopic simultaneous procedures do not increase the incidence of wound infection or recurrent IH. Moreover, they avoid repeat anesthesia and hospitalization. Therefore, this approach is safe, feasible and cost-effective for children with AA and concurrent IH.
Level Of Evidence:
Level III.
