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ORIGINAL ARTICLE
Ahead of Print

Laparoscopic versus open inguinal hernia repair in children: A systematic review


1 Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; National Clinical Research Center for Child Health and Disorders, Chongqing, China
2 National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing, China
3 Department of Urology, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
4 Department of Urology, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
5 Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatrics, Chongqing, China
6 Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China

Correspondence Address:
Lihua Kou,
Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing
China
Shengde Wu,
Department of Urology, Children's Hospital of Chongqing Medical University. No.136, Zhongshan 2nd RD, Yuzhong District, Chongqing 400014
China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_229_20

Purpose: Considerable debates exist regarding the preferable technique to repair a paediatric inguinal hernia (PIH). This systematic review aims to compare the efficacy and safety of laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in PIH. Methods: The randomised controlled trials (RCTs) that compared the outcomes of LH and OH in PIH without region and language restrictions searched from the following databases: PubMed, Web of Science Database, Cochrane Library, SciELO Citation Index, Russian Science Citation Index, China National Knowledge Infrastructure, WanFang Data and China Science and Technology Journal Database. Results: A total of 13 RCTs that involving 1207 patients included in the review. The LH displayed a shorter operative time for bilateral hernia repair (weighted mean difference = −8.23, 95% confidence interval [CI]: −11.22~−5.23, P < 0.00001), a lower complication rate (odds ratio [OR] = 0.32, 95% CI: 013–0.83, P = 0.02) along with a lower wound infection (OR = 0.14, 95% CI: 0.04–0.55, P = 0.005) and major male-specific post-operative complications (OR = 0.10, 95% CI: 0.04–0.24, P < 0.00001) and a less contralateral metachronous inguinal hernia (CMIH) incidence rate (OR = 0.09, 95% CI: 0.02–0.42, P = 0.002). No significant difference was found for unilateral operative time, time to full recovery, length of hospital stay, recurrence and hydrocele rates between the two techniques. Conclusion: The present review reiterates that both the LH and OH techniques for the PIH repair are comparable. However, in some aspects, the LH is superior to the OH in terms of operative time for bilateral hernias, post-operative complications rate and CMIH incidence rate. Rigorously designed RCTs are anticipated to confirm the clinical effects of both LH and OH.


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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04