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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Laparoscopic Hernia Sac Transection With Intracorporeal Ligation: A Comparison With Open Hernia Repair in the
Nancy Thakur1, Rakesh K Tripathi1, Pawan K Singh1
1Department of General Surgery, Ganesh Shankar Vidhyarthi Memorial Medical College, Kanpur, IND.
Insights
Open hernia repair in children is faster and leads to shorter hospital stays compared to laparoscopic repair. Both methods show similar outcomes for pain, infection rates, and return to normal activities.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Hernia Repair
Background:
- Inguinal hernia in children stems from the failure of the processus vaginalis (PV) to close.
- Surgical intervention is crucial to prevent potential complications.
Purpose of the Study:
- To compare the outcomes of laparoscopic herniotomy (LH) versus open herniotomy (OH) in pediatric patients.
- Evaluate operative time, pain, hospital stay, and complication rates.
Main Methods:
- Prospective study of 80 children (aged 1-12) with inguinal hernia.
- Patients divided into LH (38) and OH (42) groups.
- Statistical analysis included t-tests, chi-square, and descriptive statistics (p<0.05 significant).
Main Results:
- LH had a significantly longer operative time (97.89 min) than OH (31.14 min) (p<0.001).
- No significant difference in postoperative pain (p=0.776).
- Hospital stay was longer for LH (2 days) vs. OH (1 day) (p=0.001).
- Surgical site infection (SSI) rates (p=0.090) and return to school (p=0.857) were comparable.
Conclusions:
- Both laparoscopic and open hernia repair yield similar results for pain, SSI, and return to activities.
- Open herniotomy demonstrates advantages in reduced operative time and shorter hospital stays.
- Further research, including RCTs, is recommended to minimize bias and enhance understanding.
Abstract:
Background and objective Inguinal hernia in children results from a failure of the processus vaginalis (PV) to close, leading to herniation. Surgical repair is necessary to prevent complications in this patient population. This study aimed to compare the outcomes between laparoscopic herniotomy (LH) and open herniotomy (OH) in pediatric patients with inguinal hernia. Methods This prospective study included 80 children diagnosed with inguinal hernia between January 2023 and June 2024. Patients aged 1-12 years were classified into two groups: 38 underwent LH, and 42 received OH. Postoperative outcomes, including operative time, pain, hospital stay, and complications, were evaluated. Statistical analysis was performed using descriptive statistics, with a p-value <0.05 considered significant. The t-test, chi-square test, and arithmetic mean with standard deviation (SD) were used for data analysis. Results The mean operative time was significantly longer for LH (97.89 ±18.2 minutes) compared to OH (31.14 ±8.3 minutes) (p<0.001). However, pain assessment revealed no significant difference between the groups (p=0.776). Hospital stay was longer for LH patients, who were discharged on day two, compared to day one for OH patients (p=0.001). No significant differences were observed in surgical site infection (SSI) rates (p=0.090) or return to school (p=0.857). Conclusions Laparoscopic and open hernia repair are comparable in terms of postoperative pain, SSI rates, and return to normal activities. However, OH offers advantages in terms of reduced operative time and shorter hospital stays. Further studies, including randomized controlled trials, are needed to exclude selection bias and provide deeper insights into the topic.
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