Recurrence after Laparoscopic High Ligation in Adolescents: A Multicenter International Retrospective Study of Ten Hospitals
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In brief
In brief
Multicenter retrospective study of 135 adolescent patients demonstrates that laparoscopic high ligation for inguinal hernia achieves comparable recurrence rates to open repair when performed by experienced surgeons. Use of absorbable or braided sutures showed weak association with higher recurrence, suggesting suture selection may impact outcomes in this age group.
Written by the GCMD Library team from the article.
Abstract
Purpose
Inguinal hernia repairs are among the most common operations performed by pediatric surgeons. Laparoscopic high ligation is a popular technique, but its recurrence rate in adolescents is unknown. We hypothesized that recurrence after laparoscopic high ligation in adolescents would be similar to open repair (1.8%–6.3%).
Methods
We evaluated adolescent patients (12–18 years old at the time of surgery) who underwent laparoscopic high ligation across eleven hospitals. At least six months postoperatively, they were contacted by telephone for follow-up. Variables analyzed included demographics, operative details, recurrence, and other complications.
Results
A total of 144 patients were enrolled. One hospital (n=9) had a recurrence rate of 44.4%, compared to 3.0% (4/135) for the other hospitals. By accounting for 50.0% of recurrences, it represented a statistical outlier and was excluded, leaving 135 patients for analysis. The median age was 14 years, and 63.7% were male. Recurrence with the excluded center was 5.6% (8/144). Use of absorbable suture (OR 42.67, CI 4.41–412.90, p<0.01) and braided suture (OR 12.10, CI 1.54–95.25, p=0.02) was weakly associated with recurrence. Recurrence was not significantly different from published results.
Conclusion
Laparoscopic high ligation of adolescent inguinal hernias has a recurrence rate similar to open repair when performed by experienced surgeons.
Type of study
Prognosis study (retrospective study)
Level of evidence
Level II