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Open versus laparoscopic repair in pediatric incarcerated inguinal hernia: a systematic review and meta-analysis
Huang Huang1, Hongjun Wu2, Longlong Hou3
1Department of Pediatric Surgery, Shanghai Children's Medical Center GuiZhou Hospital, Guizhou Provincial People's Hospital, Guizhou, China.
Insights
Laparoscopic repair (LH) offers a shorter operative time and hospital stay for pediatric incarcerated inguinal hernias compared to open repair (OH). LH also shows reduced risks of injury and recurrence, suggesting it is a safe and effective surgical option.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- Pediatric incarcerated inguinal hernias require surgical intervention.
- The choice between laparoscopic repair (LH) and open repair (OH) is debated.
- Systematic evaluation of clinical outcomes is needed.
Purpose of the Study:
- To systematically compare clinical outcomes of laparoscopic repair (LH) versus open repair (OH).
- To evaluate pediatric incarcerated inguinal hernia management strategies.
Main Methods:
- Systematic review and meta-analysis of comparative studies.
- Literature search across major databases up to March 2026.
- Analysis of operative time, blood loss, hospital stay, injury, infection, atrophy, and recurrence.
Main Results:
- Laparoscopic repair (LH) demonstrated significantly shorter operative times and reduced blood loss compared to open repair (OH).
- LH group experienced significantly shorter hospital stays.
- LH was associated with lower risks of intraoperative injury and recurrence; no significant differences in infection or testicular atrophy.
Conclusions:
- Laparoscopic repair (LH) is a safe and effective alternative for pediatric incarcerated inguinal hernias.
- Further prospective studies are recommended to validate these findings.
Purpose:
The optimal surgical approach for pediatric incarcerated inguinal hernia remains controversial. This study aimed to systematically compare the clinical outcomes of laparoscopic repair (LH) and open repair (OH) in children with incarcerated inguinal hernia through a systematic review and meta-analysis.
Methods:
A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to March 2026. Comparative studies evaluating LH versus OH in pediatric incarcerated inguinal hernia were included. Primary outcomes included operative time, intraoperative blood loss, and length of hospital stay. Secondary outcomes included intraoperative injury, wound infection, testicular atrophy, and recurrence. Pooled mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using Review Manager 5.4.
Results:
Nine studies involving 584 pediatric patients were included in the meta-analysis. Compared with OH, LH was associated with significantly shorter operative time and reduced intraoperative blood loss. The length of hospital stay was also significantly shorter in the LH group. In addition, LH showed a significantly lower risk of intraoperative injury and recurrence. No statistically significant differences were observed between the two groups in terms of wound infection or testicular atrophy.
Conclusions:
Laparoscopic repair appears to be a safe and effective alternative to open repair for pediatric incarcerated inguinal hernia. Further high-quality prospective studies are warranted to confirm these findings.
