Laparoscopic versus open inguinal hernia repair in children: A systematic review

• Published in: Journal of minimal access surgery Vol. 18; no. 1; pp. 12 - 19
• Main Authors: Zhao, Jie, Yu, Chengjun, Lu, Jiandong, Wei, Yi, Long, Chunlan, Shen, Lianju, Lin, Tao, He, Dawei, Wei, Guanghui, Kou, Lihua, Wu, Shengde
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.01.2022; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Citation indexes; Hernias; Inguinal hernia; inguinal hernia repair; laparoscopic herniorrhaphy; Laparoscopic surgery; Laparoscopy; open herniorrhaphy; paediatric inguinal hernia; Pediatrics; Systematic Review; China; laparoscopic herniorrhaphy; laparoscopy; paediatric inguinal hernia; open herniorrhaphy; Inguinal hernia repair
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/jmas.JMAS_229_20

Considerable debates exist regarding the preferable technique to repair a paediatric inguinal hernia (PIH). This systematic review aims to compare the efficacy and safety of laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in PIH. The randomised controlled trials (RCTs) that compared the outcomes of LH and OH in PIH without region and language restrictions searched from the following databases: PubMed, Web of Science Database, Cochrane Library, SciELO Citation Index, Russian Science Citation Index, China National Knowledge Infrastructure, WanFang Data and China Science and Technology Journal Database. A total of 13 RCTs that involving 1207 patients included in the review. The LH displayed a shorter operative time for bilateral hernia repair (weighted mean difference = -8.23, 95% confidence interval [CI]: -11.22~-5.23, P < 0.00001), a lower complication rate (odds ratio [OR] = 0.32, 95% CI: 013-0.83, P = 0.02) along with a lower wound infection (OR = 0.14, 95% CI: 0.04-0.55, P = 0.005) and major male-specific post-operative complications (OR = 0.10, 95% CI: 0.04-0.24, P < 0.00001) and a less contralateral metachronous inguinal hernia (CMIH) incidence rate (OR = 0.09, 95% CI: 0.02-0.42, P = 0.002). No significant difference was found for unilateral operative time, time to full recovery, length of hospital stay, recurrence and hydrocele rates between the two techniques. The present review reiterates that both the LH and OH techniques for the PIH repair are comparable. However, in some aspects, the LH is superior to the OH in terms of operative time for bilateral hernias, post-operative complications rate and CMIH incidence rate. Rigorously designed RCTs are anticipated to confirm the clinical effects of both LH and OH.