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Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study

  • Masayuki Nakashima
  • Kazuki Ide
  • Koji KawakamiEmail author
Original Article

Abstract

Purpose

We compared the outcomes of laparoscopic surgery (LS) with those of open surgery (OS) for unilateral and bilateral pediatric inguinal hernia.

Methods

Using a nationwide claim-based database in Japan, we analyzed data from children younger than 15 years old, who underwent inguinal hernia repair between January 2005 and December 2017. Patient characteristics, incidence of reoperation, postoperative complications, length of hospital stay, and duration of anesthesia were compared between LS and OS for unilateral and bilateral hernia.

Results

Among 5554 patients, 2057 underwent LS (unilateral 1095, bilateral 962) and 3497 underwent OS (unilateral 3177, bilateral 320). The incidence of recurrence was not significantly different between OS and LS (unilateral: OS 0.2% vs. LS 0.3%, p = 0.44, bilateral: OS 0.6% vs. LS 0.6%, p = 1.00). The incidence of metachronous hernias was significantly higher in the OS group than in the LS group (4.8% vs. 1.0%, p < 0.001). The surgical site infection rate was significantly lower after OS than after LS for unilateral surgeries (0.9% vs. 2.2%, p = 0.002). There was no difference between OS and LS in the length of hospital stay.

Conclusion

Both OS and LS had a low incidence of recurrence in children; however, the incidence of metachronous hernias was lower for LS, which may influence operative technique decisions.

Keywords

Laparoscopic hernia repair Pediatric inguinal hernia Contralateral metachronous inguinal hernia Pediatric surgery 

Notes

Acknowledgements

We thank Dr. Masato Takeuchi for advice about revising the manuscript.

Compliance with ethical standards

Conflict of interest

K.K. received research funding from Olympus Corporation. M.N. and K.I. have no conflicts of interest to declare.

Supplementary material

595_2019_1847_MOESM1_ESM.docx (15 kb)
Online resource 1 MEDIS-DC codes for complications (DOCX 14 kb)

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Masayuki Nakashima
    • 1
  • Kazuki Ide
    • 1
    • 2
  • Koji Kawakami
    • 1
    • 2
    Email author
  1. 1.Department of Pharmacoepidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
  2. 2.Center for the Promotion of Interdisciplinary Education and ResearchKyoto UniversityKyotoJapan

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