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Published on: November 12, 2021
Laparoscopy Versus Open Technique for Inguinal Hernia Repair in Children: A Systematic Review and Meta-Analysis
Diogo S Almeida1, Luís Henrique A Medina2, Nathalia C Miranda1
1General Surgery, Bahiana School of Medicine and Public Health, Salvador, BRA.
Insights
Laparoscopic inguinal hernia repair in children is faster than the open technique. This minimally invasive approach showed similar rates of recurrence and complications, making it a favorable option for pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Inguinal hernias are common in children.
- Both open and laparoscopic techniques are used for repair.
- Evidence comparing these methods is crucial for surgical decision-making.
Purpose of the Study:
- To compare operative time, recurrence, and complications between laparoscopic and open inguinal hernia repair in pediatric patients.
- To provide data to inform surgical practice and patient outcomes.
Main Methods:
- Systematic review and meta-analysis of randomized clinical trials.
- Searched PubMed and Embase databases for pediatric inguinal hernia repair studies.
- Analyzed data using RevMan 5.4.1 software, assessing heterogeneity with the I² statistic.
Main Results:
- Four randomized clinical trials with 662 pediatric patients were included.
- Laparoscopic repair demonstrated a significantly shorter operative time (STD -0.75, P < 0.00001).
- Recurrence (RR 0.60, P = 0.54) and complication rates (RR 0.49, P = 0.32) were statistically similar between laparoscopic and open groups.
Conclusions:
- Laparoscopic inguinal hernia repair in children is associated with reduced operative time.
- The laparoscopic approach offers comparable safety and efficacy to open surgery regarding recurrence and complications.
- Laparoscopic repair represents an effective alternative for pediatric inguinal hernia treatment.
Abstract:
This study aims to compare operative time, recurrence, and complications between laparoscopic and open techniques for the repair of inguinal hernia in children. Pubmed and Embase databases were systematically searched for studies of pediatric patients who underwent open or laparoscopic inguinal hernia procedures. The main outcomes were operative time, recurrence, and complications. Statistical analysis was performed using RevMan 5.4.1 software (The Cochrane Collaboration, Copenhagen), and heterogeneity was assessed using the I² strategy. Four randomized clinical trials were included in the statistical analysis, totaling 662 patients, with 337 patients in the laparoscopic technique group. Operative time was significantly shorter in the laparoscopic technique group (STD -0.75, 95% CI (-1.43, -0.07), P < 0.00001, I² = 92%). Recurrence (RR 0.60, 95% CI (0.18, 2.02), P = 0.54, I² = 0%) and complications (RR 0.49, 95% CI (0.12, 2.03), P = 0.32, I² = 67%) were statistically similar between the two groups. The laparoscopic technique for inguinal hernia repair in children proved to be faster, with similar recurrence and complication rates compared to the open technique.
