Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial.

Abstract

PURPOSE:

Laparoscopy is being increasingly applied to pediatric inguinal hernia repair. In younger children, however, open repair remains preferred due to concerns related to anesthesia and technical challenges. We sought to assess outcomes after laparoscopic and open inguinal hernia repair in children less than or equal to 3 years.

METHODS:

A prospective, single-blind, parallel group randomized controlled trial was conducted at three clinical sites. Children ≤3 years of age with reducible unilateral or bilateral inguinal hernias were randomized to laparoscopic herniorrhaphy (LH) or open herniorrhaphy (OH). The primary outcome was the number of acetaminophen doses. Secondary outcomes included operative time, complications, and parent/caregiver satisfaction scores.

RESULTS:

Forty-one patients were randomized to unilateral OH (n = 10), unilateral LH (n = 17), bilateral OH (n = 5) and bilateral LH (n = 9). Acetaminophen doses, LOS, complications, and parent/caregiver scores did not differ among groups. Laparoscopic unilateral hernia repair demonstrated shorter operative time, a consistent finding for overall laparoscopic repair in univariate (p = 0.003) and multivariate (p = 0.010) analysis. No cases of testicular atrophy were documented at 2 (SD = 2.7) years.

CONCLUSION:

Children ≤3 years of age in our cohort safely underwent LH with similar pain scores, complications, and recurrence as OH. Parents and caregivers report high satisfaction with both techniques.

• Authors: Colin D Gause, Maria G Sacco Casamassima, Jingyan Yang, Grace Hsiung, Daniel Rhee, Jose H Salazar, Dominic Papandria, Howard I Pryor 2nd, Dylan Stewart, Jeffrey Lukish, Paul Colombani, Nicole M Chandler, Emilie Johnson, Fizan Abdullah
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 33 Issue 3 Pg. 367-376 (Mar 2017) ISSN: 1437-9813 [Electronic] Germany
• PMID: 28025693 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Topics

• Child, Preschool
• Female
• Hernia, Inguinal (surgery)
• Herniorrhaphy (methods)
• Humans
• Infant
• Laparoscopy (methods)
• Male
• Operative Time
• Prospective Studies
• Single-Blind Method
• Treatment Outcome