Inguinal hernioplasty in children—open or laparoscopic?: A retrospective cohort study of 1,072 cases
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In brief
In brief
This retrospective study of 1,072 pediatric inguinal hernia repairs compares traditional open surgery with the laparoscopic PIRS technique. Both approaches demonstrated equivalent safety profiles with similar complication rates, recurrence rates, and hospital stays, though PIRS identified contralateral hernias in 22% of initially unilateral cases.
- Open and laparoscopic (PIRS) inguinal hernia repair show equivalent safety profiles with no significant differences in complications or recurrence rates.
- PIRS technique identified contralateral patent processus vaginalis in 22.45% of initially unilateral cases, enabling simultaneous bilateral repair.
- Incarcerated hernias (86 cases) were successfully managed with reduction and delayed repair in 98.8% of cases, avoiding emergency surgery.
- Both techniques demonstrated low complication rates (0.56%) and acceptable recurrence rates (2.05%) in this large pediatric cohort of 1,072 surgeries.
- Hospital stay duration was comparable between open (1.3 days) and laparoscopic (1.13 days) approaches, suggesting no recovery advantage for either method.
Written by the GCMD Library team from the article.
Abstract
Purpose
The most common surgical intervention in childhood is inguinal hernioplasty. The advantage of laparoscopic approach is still questionable, therefore our aim was to compare open hernia repair (OHR) and PIRS (Percutaneous Internal Ring Suturing) technique at the authors’ institute.
Methods
An observational retrospective cohort study was conducted between 2013 and 2021. Patients were included with hernioplasties under 18 years. The number of contralateral patent processus vaginalis, length of hospital stay, complications and recurrences were analysed.
Results
1,072 surgeries were performed (OHR: 836, PIRS: 236) in 959 patients with the mean age of 4.2 years. During the study period 86 incarcerated hernias were treated: 85/86 following successful reduction with postponed surgery (77 open and eight PIRS) and 1/86 acute (open) surgery. Only six complications (OHR: 5, PIRS: 1, p = 0.86) and 22 recurrences were registered (open:15, PIRS: 7, p = 0.22). The average length of hospital stay was 1.13 days (OHR: 1.3, PIRS: 1.13 days, p = 0.82). PIRS identified contralateral patent processus vaginalis in 22.45% of cases initially diagnosed as unilateral.
Conclusions
Our findings indicate that both techniques are equally safe, with no statistically significant differences observed in terms of hospital stay duration, recurrence rates, or complication rates.