Faculty Collaboration Database

Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial. Pediatr Surg Int 2017 Mar;33(3):367-376

Date

12/28/2016

Pubmed ID

28025693

DOI

10.1007/s00383-016-4029-4

Scopus ID

2-s2.0-85007198830 (requires institutional sign-in at Scopus site)   45 Citations

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.

Author List

Gause CD, Casamassima MGS, Yang J, Hsiung G, Rhee D, Salazar JH, Papandria D, Pryor HI 2nd, Stewart D, Lukish J, Colombani P, Chandler NM, Johnson E, Abdullah F

Author

Jose Salazar Osuna MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

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