Laparoscopic vs open inguinal hernia repair in children: cohort study reports differences in outcomes
Photo by Ayanda Kunene / Unsplash
Key Takeaway
Consider that laparoscopic repair in children may detect more contralateral hernias but is observational evidence.
This was a retrospective cohort study of 9590 children undergoing inguinal hernia repair at a tertiary pediatric center. The study compared outcomes for laparoscopic versus open repair. Incarceration occurred in 4.2% of children, with a higher risk in females, children ≤1 year, and unilateral hernias. Recurrence occurred in 1.4% of children, with a higher risk in male sex and age >1 year; laparoscopic technique served as a protective factor. Laparoscopic surgery identified synchronous contralateral hernias in 39.2% of children initially diagnosed with unilateral hernia, compared with only 0.9% detected during open repair. The laparoscopic approach was associated with shorter operative time, fewer complications, and faster recovery. Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Key limitations include the retrospective design, non-randomized selection of surgical approach, and caution in interpreting comparisons between techniques. Findings emphasize individualized risk stratification and surgical decision-making, but generalizability beyond the tertiary center and long-term outcomes are uncertain.
View Original Abstract ↓
AimsTo analyze the epidemiology, clinical characteristics, surgical outcomes, and risk factors for incarceration and recurrence in a large cohort of children undergoing inguinal hernia repair, and to evaluate differences across sex, laterality, and surgical approaches.MethodsWe retrospectively reviewed the children who underwent inguinal hernia repair at a tertiary pediatric center over ten years. Demographic characteristics, perioperative outcomes, and postoperative complications were analyzed. Subgroup comparisons were performed by sex, laterality, and surgical approach. Multivariate logistic regression models were used to identify independent predictors of incarceration and recurrence.ResultsOf 9590 children, 72.2% were male, and the median age was 2 years and 10 months. Laparoscopic surgery was performed in 93.1% of cases. Incarceration occurred in 4.2% of children and recurrence in 1.4%. Females, children ≤1 year, and unilateral hernias were independently associated with higher risk of incarceration. Male sex and age >1 year predicted recurrence, while laparoscopic technique served as a protective factor. Laparoscopy identified synchronous contralateral hernias in 39.2% of children initially diagnosed with unilateral hernia, compared with only 0.9% detected during open repair. Laparoscopic approach was also associated with shorter operative time, fewer complications, and faster recovery.ConclusionsThis large cohort study highlights the epidemiology and surgical outcomes of pediatric inguinal hernia. Age, sex, and hernia laterality were associated with clinical presentation and complication risk. Laparoscopic surgery showed favorable perioperative outcomes and facilitated detection of contralateral hernias. Because surgical approach selection was not randomized, comparisons between techniques should be interpreted cautiously. These findings emphasize the importance of individualized risk stratification and surgical decision-making.
Standardized formal resuscitation training likely reduces neonatal mortality in low- and middle-income countries compared to no training or basic training.
A Simple Training Program Is Saving Newborn Lives in Poor Countries
Related in Pediatrics
Therapeutic Touch Reduces Crying and Improves Sleep in Infants With Colic
Therapeutic touch reduces crying in babies with colic
This randomized controlled trial in 96 infants with colic found that therapeutic touch based on Watson's Human Care Theory significantly red…
A new trial shows gentle therapeutic touch helps babies cry less and sleep better when they have infantile colic.
Mycophenolate mofetil non-inferior to prednisone for first-episode nephrotic syndrome in children
Mycophenolate Mofetil Offers Alternative to Steroids for Nephrotic Syndrome
This phase 3 non-inferiority trial randomized 272 children aged 1-10 years with first-episode steroid-sensitive nephrotic syndrome to mycoph…
A new trial shows mycophenolate mofetil works as well as prednisone for children with nephrotic syndrome, with fewer steroid side effects.
AquOTic water competency intervention improves outcomes in children with autism
Water therapy improves skills for children with autism spectrum disorder
This pre-post cohort study of 37 children with autism ages 5 to 9 found that a 10-week occupational therapy-based water competency intervent…
A water-based occupational therapy program significantly improved performance and satisfaction scores in children with autism spectrum disor…
Play-based cognitive flexibility training boosts creativity in third graders
Playful workshops boost story skills and flexible thinking for third graders
This RCT in 249 third graders found that a 14-session play-based workshop significantly improved narrative creativity and cognitive flexibil…
A fun 14-session workshop helped third graders write better stories and think more flexibly than peers in regular classes.
From Other Specialties
Phase 1 study traces ainuovirine metabolism and excretion in healthy men
A single dose of oral ainuovirine clears the body within two days in healthy men
This phase 1 open-label study in 6 healthy men examined the pharmacokinetics and mass balance of a single dose of radiolabelled ainuovirine.…
A single dose of oral ainuovirine clears the body within two days in healthy men, with most of the drug leaving unchanged through urine and …
Nirmatrelvir/Ritonavir in Breast Milk: Low Infant Exposure in Lactating Women
Paxlovid levels low in breast milk, early study finds
This Phase 1 open-label study in 8 healthy lactating women found that nirmatrelvir/ritonavir concentrations in breast milk were consistently…
A small study finds that nirmatrelvir/ritonavir (Paxlovid) passes into breast milk at low levels, suggesting minimal infant exposure.
Islatravir and lenacapavir fixed-dose combination shows similar bioavailability to single agents in healthy volunteers
New HIV pill works with or without food in early safety tests
This open-label phase 1 study enrolled 93 people without HIV to assess the oral relative bioavailability and safety of a fixed-dose combinat…
A new HIV pill containing islatravir and lenacapavir showed similar drug levels whether taken with food or on an empty stomach, supporting f…
Digital chest radiography with CAD shows variable sensitivity for asymptomatic tuberculosis in South African adults
Digital scans miss many silent tuberculosis cases in South Africa adults
This cohort study evaluated digital chest radiography (dCXR) read by blinded human readers and qXR CAD in 1353 adults in South Africa. The s…
New data from South Africa shows digital scans and computer tools miss many silent tuberculosis cases, raising questions about current scree…