Comparison of laparoscopic hernia repair and open herniotomy in children: a retrospective cohort study.
BACKGROUND
Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic-assisted hernia repair (LH) versus open herniotomy (OH) as regards operative time, postoperative complications, recurrence rate, and contralateral metachronous hernia rate.


METHODS
We analyzed all the patients with inguinal hernia who underwent surgery in our hospital from January 1, 2015 to December 31, 2015. There were 1125 patients, of which 202 patients received laparoscopic inguinal hernia repair (group A) and 923 patients received open herniotomy (group B). We recalled all the patients' records to identify operative time, postoperative hydrocele formation, and contralateral patent processus vaginalis (CPP) detection; we recalled all the patients' parents to identify the ipsilateral and contralateral recurrence and the testis position.


RESULTS
During the study period, the lost to follow-up rate is 9.9% in group A and 14.1% in group B. The mean follow-up period was about 10.1 months. The mean operative time for females with bilateral hernia in group A was much shorter than that for those in group B (P = 0.001). The postoperative hydrocele formation rate in group A was 1.5%, compared with 8.2% in group B (P = 0.001). The recurrence rate was 0.64% in group A, whereas in group B the recurrence rate was 0.46%. Of patients with unilateral hernia, none in group A experienced a contralateral metachronous hernia (MH) compared with 10.1% in group B (P < 0.001) and 65% MH appeared in 3 months after the first hernia repair. Females and patients with initial left-sided hernia tended to have a contralateral MH after the first open hernia repair.


CONCLUSION
Laparoscopic hernia repair in children is safe and effective, especially for female patients and patients with initial left-sided hernia. We recommend repairing the CPP simultaneously when performing laparoscopic procedures.
['Zhu|L L|LL|', 'Xu|W J|WJ|', 'Liu|J B|JB|', 'Huang|X|X|', 'Lv|Z B|ZB|']
D002648:Child D002675:Child, Preschool D016208:Databases, Factual D005260:Female D006552:Hernia, Inguinal D059685:Herniorrhaphy D006801:Humans D007223:Infant D010535:Laparoscopy D008297:Male D012189:Retrospective Studies
Laparoscopic hernia repair Inguinal hernia Pediatric