Long-term absorbable versus non-absorbable suture in laparoscopic percutaneous extraperitoneal closure of internal ring for inguinal hernia in children

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Aim: To compare the results of using long-term absorbable (LTAS) versus non-absorbable suture (NAS) in laparoscopic percutaneous extraperitoneal closure of internal ring (LPEC) for indirect inguinal hernia (IH) in children METHODS: Prospectively collected data from children undergoing LPEC for IH at our center were retrospectively reviewed to compare group A repaired with NAS (2.0 monofilament polypropylene or braided polytetrafluoroethilene) to group B repaired with LTAS 2.0 polydioxanone.

Results: 481 patients with 499 IHs in group A were compared to 277 patients with 283 IHs in group B. There were no significant differences in terms of age, bodyweight and laterality of IH between the two groups. At a median follow up period of 30 months, the incidence of suture knot reaction (SKR) and hernia recurrence were 3.1% and 1.0% in group A vs. 0% and 6.4% in group B with p = 0.002 and p<0.001, respectively. Monofilament NAS was associated with a low rate of both recurrence and SKR.

Conclusions: LPEC repair for pediatric IH using LTAS is associated with no SKR but a higher recurrence rate compared to NAS. Monofilament NAS such as Prolene could be a good choice in LPEC because of its low rate of both recurrence and SKR.

DOI:10.1016/j.jpedsurg.2021.03.019

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