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

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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.

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto, 606-8501, Japan

    Masayuki Nakashima, Kazuki Ide & Koji Kawakami

  2. Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto, 606-8501, Japan

    Kazuki Ide & Koji Kawakami

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  1. Masayuki Nakashima
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Correspondence to Koji Kawakami.

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

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Nakashima, M., Ide, K. & Kawakami, K. Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study. Surg Today 49, 1044–1050 (2019). https://doi.org/10.1007/s00595-019-01847-0

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