A 10-year review of pediatric inguinal hernia management at a tertiary center

To analyze the epidemiology, clinical characteristics, surgical outcomes, and risk factors for incarceration and recurrence in a large cohort of children undergoing inguinal hernia repair, and to evaluate differences across sex, laterality, and surgical approaches.

We retrospectively reviewed the children who underwent inguinal hernia repair at a tertiary pediatric center over ten years. Demographic characteristics, perioperative outcomes, and postoperative complications were analyzed. Subgroup comparisons were performed by sex, laterality, and surgical approach. Multivariate logistic regression models were used to identify independent predictors of incarceration and recurrence.

Of 9590 children, 72.2% were male, and the median age was 2 years and 10 months. Laparoscopic surgery was performed in 93.1% of cases. Incarceration occurred in 4.2% of children and recurrence in 1.4%. Females, children ≤1 year, and unilateral hernias were independently associated with higher risk of incarceration. Male sex and age >1 year predicted recurrence, while laparoscopic technique served as a protective factor. Laparoscopy identified synchronous contralateral hernias in 39.2% of children initially diagnosed with unilateral hernia, compared with only 0.9% detected during open repair. Laparoscopic approach was also associated with shorter operative time, fewer complications, and faster recovery.

This large cohort study highlights the epidemiology and surgical outcomes of pediatric inguinal hernia. Age, sex, and hernia laterality were associated with clinical presentation and complication risk. Laparoscopic surgery showed favorable perioperative outcomes and facilitated detection of contralateral hernias. Because surgical approach selection was not randomized, comparisons between techniques should be interpreted cautiously. These findings emphasize the importance of individualized risk stratification and surgical decision-making.