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Laparoscopic versus Open Incarcerated Inguinal Hernia Repair in Children: A Systematic Review and Meta-Analysis
Syukri Ahmad Zubaidi1, Don Evana Ezrien1, Yong Chen2
1Division of Paediatric Surgery, Department of General Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Summary
Laparoscopic hernia repair (LH) in children with incarcerated inguinal hernias (IIH) leads to fewer major complications and shorter hospital stays compared to open repair (OH). However, more research, including randomized controlled trials, is needed.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- The efficacy of laparoscopic hernia repair (LH) in pediatric incarcerated inguinal hernia (IIH) remains undefined compared to open repair (OH).
- This study systematically reviews and compares outcomes of LH versus OH for pediatric IIH.
Approach:
- A systematic review of retrospective cohort studies published between 2000 and 2018 was conducted.
- Studies comparing LH and OH in children (≤18 years) for IIH were included, analyzing major and minor complications.
- Meta-analyses were performed using random- or fixed-effects models, with significance set at p < 0.05.
Key Points:
- Laparoscopic repair was associated with significantly fewer overall major complications (OR=0.38, p=0.02) compared to open repair.
- The length of hospital stay was shorter for laparoscopic repair (WMD=-1.39 days, p=0.02).
- No significant differences were found between the groups for individual complication types.
Conclusions:
- Laparoscopic repair for pediatric incarcerated inguinal hernia is linked to reduced major complications and shorter hospital stays.
- The current evidence is limited by the lack of randomized controlled trials, necessitating further investigation.
