Volume 15, Issue 2 pp. 290-298

Original ARTICLE

Risks and benefits of pediatric inguinal hernia repair: Conventional open repair vs laparoscopic percutaneous extraperitoneal closure

Masashi Kurobe,

Corresponding Author

Masashi Kurobe

[email protected]

orcid.org/0000-0001-8738-1798

Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

Correspondence

Masashi Kurobe, Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, 180 Nishi-araijuku, Kawaguchi, Saitama 333-0833, Japan.

Email: [email protected]

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Tetsuro Sugihara,

Tetsuro Sugihara

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Atsushi Harada,

Atsushi Harada

Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

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Sayuri Kaji,

Sayuri Kaji

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Goki Uchida,

Goki Uchida

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Daisuke Kanamori,

Daisuke Kanamori

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Yuji Baba,

Yuji Baba

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Tomomasa Hiramatsu,

Tomomasa Hiramatsu

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Shinsuke Ohashi,

Shinsuke Ohashi

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Masahiko Otsuka,

Masahiko Otsuka

Department of Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

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Masashi Kurobe,

Corresponding Author

Masashi Kurobe

[email protected]

orcid.org/0000-0001-8738-1798

Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

Correspondence

Masashi Kurobe, Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, 180 Nishi-araijuku, Kawaguchi, Saitama 333-0833, Japan.

Email: [email protected]

Search for more papers by this author

Tetsuro Sugihara,

Tetsuro Sugihara

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

Search for more papers by this author

Atsushi Harada,

Atsushi Harada

Department of Pediatric Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

Search for more papers by this author

Sayuri Kaji,

Sayuri Kaji

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

Search for more papers by this author

Goki Uchida,

Goki Uchida

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

Search for more papers by this author

Daisuke Kanamori,

Daisuke Kanamori

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Yuji Baba,

Yuji Baba

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Tomomasa Hiramatsu,

Tomomasa Hiramatsu

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Shinsuke Ohashi,

Shinsuke Ohashi

Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan

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Masahiko Otsuka,

Masahiko Otsuka

Department of Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan

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First published: 03 October 2021

https://doi.org/10.1111/ases.12997

Citations: 4

All authors are in agreement with the content of the manuscript.

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Abstract

Introduction

Considerable debate exists regarding the benefits of laparoscopic percutaneous extraperitoneal closure (LPEC) over conventional open repair (OR). We assessed the outcomes and feasibility of LPEC compared to OR for pediatric inguinal hernia (IH).

Methods

We retrospectively analyzed 570 children who underwent LPEC or OR. Parents decided the operative method after obtaining informed consent. Patient characteristics, operative time, complications and contralateral metachronous IH (CMIH) were compared between the groups.

Results

A total of 329 children underwent LPEC and 241 underwent OR. There was no significant difference in the incidence of recurrence or testicular ascent between the LPEC and OR groups (0.3% vs 0.4%, P = 0.825, 0.3% vs 0.8%, P = 0.391, respectively). No testicular atrophy was recognized in either group. One patient with postoperative chronic inguinal pain was recognized in each group. There was no surgical site infection (SSI) in the OR group; however, the LPEC group more frequently demonstrated umbilical port site (UPS)-related complications, such as incisional hernia, minor deformity, granuloma formation, cellulitis and superficial SSI. Ten (4.1%) developed CMIH in OR; in contrast, no case of CMIH was experienced after LPEC (P < 0.001).

Conclusion

In conclusion, both LPEC and OR are feasible in the management of pediatric IH, because of their high success rates and low risk of complications. LPEC could be the superior procedure with respect to the prevention of CMIH. However, to maximize the merits of LPEC over OR, it is important to reduce UPS-related complications in LPEC. A longer follow-up is needed to assess male fertility in patients who receive LPEC.

CONFLICT OF INTEREST

The authors declare no conflicts of interest in association with the present study.

Open Research

DATA AVAILABILITY STATEMENT

Research data are not shared.

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Citing Literature

Volume15, Issue2

April 2022

Pages 290-298

Risks and benefits of pediatric inguinal hernia repair: Conventional open repair vs laparoscopic percutaneous extraperitoneal closure

Abstract

Introduction

Methods

Results

Conclusion

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Information

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Risks and benefits of pediatric inguinal hernia repair: Conventional open repair vs laparoscopic percutaneous extraperitoneal closure

Abstract

Introduction

Methods

Results

Conclusion

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

Related

Information